Presented by: Vibha Sabharwal MD
U Chicago Medicine Advent Health

Introduction

Although a very effective procedure for BPH, Aquablation of the prostate can be associated with significant blood loss. This study was designed to determine if the use of tranexamic acid at induction had any benefit during Aquablation of the prostate.

Materials

A total of 23 patients were included in the study. The same surgeon performed all of the operations. Twelve patients were randomized to receive no tranexamic acid, and 11 patients were given 1 gram of tranexamic acid at induction of anesthesia

Results

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There was no difference in intraoperative blood loss in either group (75 cc in no TXA group vs 72cc in the TXA group). Length of stay in the hospital was also similar in both groups (1.9 days in no TXA group vs 1.6 days in TXA group).  However, the average operative time was reduced by 13 minutes in the tranexamic acid group (54min vs 68min).  Furthermore, the average drop in hemoglobin on postoperative day one was double in the non-TXA group (0.8 units) versus the TXA group (0.4 units).  No thromboembolic events occured in the immediate postoperative period in either group. 

Conclusion

Although this small  study did not show a significant difference in intraoperative blood loss with the use of TXA during Aquablation of the prostate, there does appear to be some benefit. Shorter operative time suggests earlier control of bleeding. Furthermore, the drop in  hemoglobin was much less in the TXA group compared to the non TXA group. This may suggest some benefit in controlling ongoing bleeding after surgery.

Funding

n/a

Co-Authors

Kevin Hilton, MD
Quincy Medical Group

David Nusbaum, MD
University of Chicago Medical Center