Evaluating the effectiveness of tranexamic acid administration in reducing bleeding in benign prostate hyperplasia patients underwent open prostatectomy: A double-blind randomized clinical trial

J Res Med Sci. 2023 Feb 21:28:8. doi: 10.4103/jrms.jrms_308_22. eCollection 2023.


Background: Blood loss of postoperative after prostate surgery could be related with an increase in urinary fibrinolytic activity. Tranexamic acid (TXA) is both a potent inhibitor of plasminogen and urokinase activators and a low molecular weight substance that is excreted unchanged in the urinary tract and can be administered both orally and intravenously. This study aimed to evaluate the effectiveness TXA administration in reducing bleeding in benign prostatic hyperplasia (BPH) patients who underwent open prostatectomy.

Materials and methods: This double-blind randomized clinical trial was conducted on patients with BPH who underwent open prostatectomy. The first group received TXA (1 gr IV from during surgery to 48 h after surgery, 3 times/day). Twenty-four hours after surgery, the two groups were compared in terms of bleeding rate. Hemoglobin (Hb), hematocrit (HCT), and platelet (Plt) counts were also assessed before and after the intervention.

Results: Intervention and control groups were comparable in terms of basic and baseline values of variables at the beginning of the study (P > 0.05). The mean bleeding volume in TXA group was significantly lower than the control group 112.11 ± 53.5 and 190.00 ± 97.5 CC; P ≤ 0.001). Mean hospitalization (3.28±0.46 vs. 4.38 ± 0.95 days P < 0.001) and surgery duration (98.11 ± 37.11 vs. 128.00 ± 39.12 h; P = 0.001) were significantly lower in TXA group compared to control intervention.

Conclusion: According to the findings of the current study, the administration of TXA led to reduce bleeding in BPH patients who underwent open prostatectomy. Furthermore, the mean Hb, HCT, levels were significantly affected by TXA. TXA treatment approach also can reduce the surgery and hospitalization time effectively. TXA approach is recommended as effective procedure in BPH patients who underwent open prostatectomy.

Keywords: Benign prostate disease; bleeding; open prostatectomy; tranexamic acid.