Local Administration of Tranexamic Acid During Prostatectomy Surgery: Effects on Reducing the Amount of Bleeding

Abstract

BackgroundOne of the issues in prostatectomy surgery is bleeding. Although tranexamic acid (TRA) is an antifibrinolytic agent for reducing bleeding, controversies surround its use.ObjectivesIn this study, the effect of local administration of TRA on reducing bleeding during prostatectomy surgery was evaluated.MethodsA total of 186 patients who underwent prostatectomy surgery were assessed in this clinical trial study. Patients were divided randomly into two groups. After prostate removal, TRA (500 mg TRA with 5 mL total volume) to the intervention group and normal saline to the control group were sprayed with the same volume. At the end of surgery, the prescribed blood bags were measured and recorded. Hemoglobin and platelet levels were recorded 6 hours after the test. Moreover, the amounts of blood inside the blood bags in the first 24 hours, the second 24 hours, and the total length of hospital stay were recorded and compared in each group.ResultsBy comparing the measured values before and after surgery, we found that the amounts of hemoglobin, hematocrit, and platelet decreased. The mean blood loss in the intervention group was recorded at 340 mL and that in the control group was 515 mL. The maximum bleeding in the control group was almost twice as much as that in the intervention group. Blood loss in the intervention group with the administration of TRA was significantly lesser than that in the control group (P = 0.01). The decrease in platelet level in the intervention group was significantly lower than that in the control group (P = 0.03).ConclusionsThe present study showed that local administration of TRA significantly reduces bleeding after prostatectomy surgery and is effective in preventing postoperative hemoglobin decrease.

Can tranexamic acid in irrigation fluid reduce blood loss during monopolar transurethral resection of the prostate? A randomised controlled trial

“…Additionally, there was a significant difference between the two groups’ serum HCT at both 4- and 24-h postoperatively. The Pourfakhr et al [ 9 ] study agrees with our present study, as they reported that a local administration of TXA significantly reduced postoperative HCT loss ( P = 0.05).…”

Use of Tumescent Anesthesia in Surgical Excision of Gynecomastia

“…Topical action of tranexamic acid has shown favorable results in reducing blood loss in total knee arthroplasty and prostatectomy. 16,17 However, no study has been made for its use in tumescent anesthesia. Previously, standard tumescent anesthesia was used, and some amount of blood loss was encountered which needed electrocauterization.…”

Can the prophylactic administration of tranexamic acid reduce the blood loss after robotic assisted radical prostatectomy? RARPEX (Robotic Assisted Radical Prostatectomy with TranEXamic acid): study protocol for a randomized controlled trial (SPIRIT Compliant)

“…Increasing evidence of the bene cial use of tranexamic acid in cardiac surgery, neurosurgery, traumatology, and orthopedics has led to the renewal of this idea (18)(19)(20). However, newer urological papers continue to produce ambiguous results, from clearly negative (21) to con rmation of the positive effect (22)(23)(24)(25), including a recent meta-analysis (26). Therefore, this trial was conducted in order to clarify this issue.…”