To assess the role of intraprostatic injection of tranexamic acid (TXA) in reducing blood loss
during transurethral resection of the prostate (TURP).
METHODS We conducted a randomized, controlled, double-blind trial involving 60 patients with benign
prostatic hyperplasia aged 50-85 years, undergoing monopolar TURP. Patients’ prostatic
weights ranged from 50 to 80 g. They were divided equally into two groups: group I received an
intraprostatic injection of 1 g of TXA (Cyklokapron) dissolved in 50 mL of 0.9 % saline at
multiple sites, while group II (control) received a 60 mL saline injection. Comprehensive
clinical assessments and standard laboratory tests, including screenings for TXA hypersensitivity,
were performed for all patients.
RESULTS Group I exhibited significantly lower intraoperative blood loss and hemoglobin concentration in
irrigation fluid immediately postsurgery and at the 6-hour postoperative mark compared to group
II (P < .05). Coagulation parameters—activated partial thromboplastin time, prothrombin
time, fibrinogen level, and thrombin clotting time—showed no significant differences between
the groups preoperatively or at 6 and 24 hours postoperatively. No thromboembolic events or
other complications were reported in either group.
CONCLUSION The intraprostatic injection of TXA during monopolar TURP is safe, with minimal adverse
effects, and effectively reduces blood loss.
REGISTRATION The study was registered on ClinicalTrials.gov No (ID: NCT05913466). UROLOGY xx: xxx–
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