Blood loss related to transurethral resection of the prostate (TURP) is a significant cause of morbidity, especially in larger glands. Aim: To determine the effectiveness of short-term treatment with Tranexamic acid (TXA), a potent antifibrinolytic, in reducing the blood loss related to TURP. Materials and Methods: One hundred patients with benign prostatic hyperplasia requiring TURP were randomly allocated into treatment and control groups (50 patients in each). Based on prostate volume, patients were categorized into groups A (40-49cc) (n=30), B (50-69cc) (n=58), C (70-75cc) (n=12). Each group had Treatment (received TXA) and Control subgroups. The selected patients were given 10mg/kg TXA intravenously, 1 hour prior to surgery and two doses post operatively, eighth hourly. Serum hemoglobin on the 1st post operative day, volume and hemoglobin concentration of the irrigation fluid, amount of tissue resected, duration of surgery were compared between the test and control groups. Also the number of patients presenting with delayed hematuria, clot retention and requiring transfusion were compared. Results: Mean blood loss 323ml vs 527 ml (p= 0.000) in test and control subgroups respectively, in Group B. Blood loss/gram (ml/g) of resected tissue was 9.7 vs 13.5 (p= 0.000) in Group A, 11.3 vs 21.5 (p= 0.000) in Group B, 17.3 vs 21.5 (p =0.002) in Group C. The hemoglobin loss in the irrigating fluid was significantly lower in the group of patients given TXA than in the control group (p<0.01). Conclusion: Short-term TXA treatment is effective in reducing the blood loss related to TURP and also improving surgical outcomes.
