AB010. SOH25AB_036. The role of tranexamic acid in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials
Urology Session

AB010. SOH25AB_036. The role of tranexamic acid in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials

Cian Hehir1, Gavin Calpin2, Gavin Dowling1, Gordon Daly1, Barry McGuire2

1Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Urology, St. Vincent’s University Hospital, Saint Vincent’s University Hospital, Dublin, Ireland

Background: Transurethral resection of the prostate (TURP) remains the gold standard in surgical management of patients with symptomatic benign prostatic hyperplasia (BPH). Intraoperative bleeding represents a common complication of TURP and is known to decrease surgical field visualisation and prolong operative time. This study aims to evaluate the role of tranexamic acid (TXA) in TURP with respect to blood loss, perioperative morbidity and operative time.

Methods: A systematic search was performed in accordance with PRISMA guidelines to identify randomised controlled trials (RCTs) evaluating the effect of TXA in TURP published until October 2024. Studies were screened by two independent researchers. Data were exported and analysed using RevMan© 5.4.

Results: Nine RCTs met the inclusion criteria for this meta-analysis in which a total of 661 patients underwent TURP for BPH. There was significantly less intraoperative bleeding in the TXA group. This was reflected in a significantly less haemoglobin drop on the first postoperative day. TXA was associated with a significantly shorter operative time with patients who received TXA exposed to a significantly lower risk of blood transfusion. There was no statistically significant increase in risk of deep vein thrombosis (DVT) in the TXA group.

Conclusions: Perioperative administration of TXA is safe and effective in reducing intraoperative blood loss, operative time and postoperative reduction in haemoglobin. This meta-analysis did not detect any significant increase in thromboembolic risk incurred by TXA administration.

Keywords: Tranexamic acid (TXA); transurethral resection of the prostate (TURP); benign prostatic hyperplasia (BPH); bleeding; operative time

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab010
Cite this abstract as: Hehir C, Calpin G, Dowling G, Daly G, McGuire B. AB010. SOH25AB_036. The role of tranexamic acid in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials. Mesentery Peritoneum 2025;9:AB010.

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