MP46-17 TRANEXAMIC ACID DOES NOT IMPACT HoLEP CLINICAL OUTCOMES

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III (MP46)1 May 2024MP46-17 TRANEXAMIC ACID DOES NOT IMPACT HoLEP CLINICAL OUTCOMES Maria C. Velasquez, Pablo A. Suarez, Wilson Sui, Heiko Yang, Sultan Al Alzzawi, Jorge Mena, Justin Ahn, and Thomas Chi Maria C. VelasquezMaria C. Velasquez , Pablo A. SuarezPablo A. Suarez , Wilson SuiWilson Sui , Heiko YangHeiko Yang , Sultan Al AlzzawiSultan Al Alzzawi , Jorge MenaJorge Mena , Justin AhnJustin Ahn , and Thomas ChiThomas Chi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008668.53858.38.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is becoming the gold standard for surgical treatment of benign prostatic hyperplasia. While the procedure is safe and produces durable outcomes, perioperative bleeding remains a concern. Tranexamic acid (TXA) has been studied as an adjunctive therapy to promote effective postoperative hemostasis. Yet, the utility of TXA remains understudied. We aimed to determine if preoperative TXA plays a role in immediate postoperative outcomes. METHODS: A retrospective cohort study on patients undergoing HoLEP from a single academic institution from 2018-2022 was conducted. After 2019, in order to facilitate same day discharge, all patients undergoing HoLEP were given TXA unless medically contraindicated. Demographic, clinical and disease-specific patient characteristics, and surgical outcomes were abstracted. The primary outcomes were estimated blood loss (EBL), postoperative transfusion rate, length of stay and Clavien II or greater complications. Statistical comparisons between patients receiving TXA versus no TXA were performed using parametric tests (Fisher's exact and t tests). Multivariable linear and logistic regression models were used for numerical and categorical variables respectively. RESULTS: Of the 250 patients who were identified, 39.6% of patients received TXA while 60.4% did not. Patients in both groups had similar mean ages (71.2±6.7 vs 70.4±10.8; p=0.51) and prostate sizes (110.4 (63.4) vs 97.4 (66.2); p=0.13). Those who received TXA had lower rates of hypertension (47.5 vs 68.9%); p=<0.001), anticoagulant use (5.1% vs 16.6%; p=0.006), and preoperative catheterization (27.3% vs 47%, p=0.034), but higher rates of ASA 1-2 scores (86.9% vs 53.6%; p=<0.001). Unadjusted analysis showed that the TXA group had lower postoperative transfusion rates (1.1% vs 6.6%, p-value= 0.051.) The multivariate regression model showed that TXA administration had no effect on perioperative outcomes (p-values >0.05) including transfusion rate (Table 1). CONCLUSIONS: These findings support recent evidence suggesting that TXA has no impact on perioperative outcomes, such as blood loss, postoperative transfusion, prolonged length of stay, and Clavien II or greater complications. Its value should be considered in the dimensions of impact on surgical visibility and procedure length in future studies. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e759 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maria C. Velasquez More articles by this author Pablo A. Suarez More articles by this author Wilson Sui More articles by this author Heiko Yang More articles by this author Sultan Al Alzzawi More articles by this author Jorge Mena More articles by this author Justin Ahn More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...