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

Figures & data

Figure 1. Consolidated Standards of Reporting Trials (CONSORT) flow chart.

Table 1. Comparison between the two groups regarding preoperative data

Variable	Control group (N = 25)	TXA group (N = 25)	P
Age, years, mean (SD, range)	68.88 (7.82, 57–80)	69.36 (7.88, 57–80)	0.830
Prostate size, g, mean (SD, range)	68.88 (9.27, 50–80)	70.28 (9.17, 50–80)	0.594
Preoperative PVR, mL, median (IQR)	320 (210–500)	325 (240–500)	0.879
Postoperative PVR, mL, median (IQR)	0	0
Total PSA, ng/mL, mean (SD, range)	6.15 (1.2, 4–10)	5.57 (1.04, 3–7.2)	0.074
Free PSA, ng/mL, mean (SD, range)	1.42 (0.34, 1–2.5)	1.58 (0.33, 1–2.2)	0.106
Preoperative IPSS, mean (SD, range)	26.96 (4.16, 19–35)	25.84 (3.59, 19–33)	0.313
Postoperative IPSS, mean (SD, range)	7.96 (2.46, 4–14)	8.12 (2.39, 4–14)	0.816
Preoperative
Hb, g/dL, mean (SD, range)	13.70 (0.77, 12–15)	14.11 (0.82, 12–16)	0.077
HCT, %, mean (SD, range)	42.96 (1.88, 40–47)	42.88 (2.22, 39–27)	0.891
4-h postoperatively
Hb, g/dL, mean (SD, range)	12.6 (0.82, 10.6–14.1)	13.24 (0.77, 11.5–15)	0.006
HCT, %, mean (SD, range)	34.68 (1.52, 32–38)	36.96 (1.37, 34–39)	<0.001
24-h postoperatively
Hb, g/dL, mean (SD, range)	12.33 (0.85, 10.3–13.8)	13.01 (0.78, 11.2–14.8)	0.005
HCT, %, mean (SD, range)	32.48 (1.5, 31–37)	34.8 (1.38, 32–37)	<0.001

PVR, post-void residual urine volume.

Table 2. Comparison between the two study groups for blood loss, Hb concentration in the irrigation fluid and the irrigation volume at the three time-points (T1, T2, T3)

	Control group (N = 25)	TXA group (N = 25)	P
Blood loss, mL, mean (SD, range)
T1	500.28 (96.69, 346–777)	395.44 (109.73, 286–740)	0.001
T2	56.6 (12.66, 34–90)	36.6 (15.74, 16–93)	<0.001
T3	87.28 (17.17, 51–126)	51.4 (16.89, 20–83)	<0.001
Total	644.16 (101.17, 478–924)	483.44 (113.49, 360–815)	<0.001
Irrigation fluid Hb concentration, g/dL, mean (SD, range)
T1	0.26 (0.05, 0.2–0.4)	0.23 (0.06, 0.16–0.37)	0.018
T2	0.15 (0.02, 0.12–0.19)	0.12 (0.05, 0.04–0.28)	0.005
T3	0.07 (0.02, 0.02–0.1)	0.06 (0.02, 0.02–0.09)	0.705
Total	0.48 (0.06, 0.4–0.64)	0.41 (0.09, 0.28–0.6)	0.003
Irrigation volume, mL, mean (SD, range)
T1	2530.20 (130.22, 2200–2700)	2420.80 (130.85, 2200–2800)	0.009
T2	510 (80.78, 350–650)	430.16 (100.69, 300–700)	0.007
T3	1470.00 (110.90, 1200–1650)	1380.20 (140.13, 1000–1600)	0.021
Total	4510.20 (200.93, 4050–4850)	4240.16 (270.35, 3700–4750)	<0.001

Table 3. Comparison between the two groups for complications, bleeding profile, surgery duration, hospital stay and quality of endoscopic view

Variable	Control group (N = 25)	TXA group (N = 25)	P
Complications, n (%) No TUR syndrome	24 (96.0) 1 (4.0)	25 (100.0) 0	0.312
INR, mean (SD)	1.03 (0.06)	1.02 (0.04)	0.427
Surgery duration, min, mean (SD)	99.2 (8.74, 80–120)	91.4 (6.85, 80–100)	0.001
Hospital stay, days, mean (SD)	2.12 (0.33, 2–3)	2.04 (0.2, 2–3)	0.307
Quality of endoscopic view, n (%) Poor Fair Good	5 (20.0) 15 (60.0) 5 (20.0)	3 (12.0) 8 (32.0) 14 (56.0)	0.032

INR, international normalised ratio.