Indian Journal of Urology
REVIEW ARTICLE
Year
: 2022  |  Volume : 38  |  Issue : 4  |  Page : 258--267

The role of tranexamic acid in reducing bleeding during transurethral resection of the prostate: An updated systematic review and meta-analysis of randomized controlled trials


Firmantya Hadi Pranata, Yudhistira Pradnyan Kloping, Furqan Hidayatullah, Zakaria Aulia Rahman, Niwanda Yogiswara, Ilham Akbar Rahman, Nafis Audrey Febriansyah, Doddy Moesbadianto Soebadi 
 Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

Correspondence Address:
Doddy Moesbadianto Soebadi
Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java
Indonesia

Introduction: Transurethral resection of the prostate (TURP) is regarded as the current gold standard surgical intervention for benign prostatic hyperplasia (BPH). However, this procedure is associated with significant chances of intraoperative and postoperative bleeding. Several studies have reported the role of tranexamic acid in prostatic surgeries, but, its role in TURP is still unclear. This review aims to evaluate the role of tranexamic acid in reducing the blood loss during TURP. Materials and Methods: A systematic search was performed on Medline, Scopus, Embase, and Cochrane, up to December 2021. Relevant randomized controlled trials (RCTs) evaluating the role of tranexamic acid in TURP were screened using our predefined eligibility criteria. Data were expressed as odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CIs). All analyses were performed using RevMan 5.4 (Cochrane Collaboration, UK). Results: Six trials were included in this meta-analysis, comprising of 582 patients with BPH who underwent TURP. The meta-analysis revealed an insignificant difference in the rate of blood transfusion (OR 0.68, 95% CI 0.34, 1.34, P = 0.27) but, a significantly lower amount of blood loss and a lower reduction in the hemoglobin (Hb) levels in the patients receiving tranexamic acid as compared to the control group (MD − 127.03, 95% CI − 233.11, −20.95, P = 0.02; MD − 0.53, 95% CI − 0.84, −0.22, P < 0.01; respectively). Also, the operative time (P = 0.12) and the length of hospitalization (P = 0.59) were similar between the two groups. Conclusion: The administration of tranexamic acid was not found to be effective in reducing the need for blood transfusion, the operative time, and the length of hospitalization during the TURP. However, it could reduce the amount of blood loss and the fall in the Hb levels.


How to cite this article:
Pranata FH, Kloping YP, Hidayatullah F, Rahman ZA, Yogiswara N, Rahman IA, Febriansyah NA, Soebadi DM. The role of tranexamic acid in reducing bleeding during transurethral resection of the prostate: An updated systematic review and meta-analysis of randomized controlled trials.Indian J Urol 2022;38:258-267


How to cite this URL:
Pranata FH, Kloping YP, Hidayatullah F, Rahman ZA, Yogiswara N, Rahman IA, Febriansyah NA, Soebadi DM. The role of tranexamic acid in reducing bleeding during transurethral resection of the prostate: An updated systematic review and meta-analysis of randomized controlled trials. Indian J Urol [serial online] 2022 [cited 2022 Dec 6 ];38:258-267
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2022;volume=38;issue=4;spage=258;epage=267;aulast=Pranata;type=0