Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial

Abstract Background Transurethral resection of the prostate (TURP) surgery, as a common surgical technique for cases of benign prostatic hyperplasia, can often lead to various complications during and after the procedure. Among these, intraoperative bleeding and postoperative shivering are highly pr...

Full description

Saved in:
Bibliographic Details
Main Authors: Masoomeh Salehi, Behzad Imani, Shirdel Zandi, Hamed Haghiabi, Somayeh Souri
Format: Article
Language:English
Published: SpringerOpen 2025-01-01
Series:African Journal of Urology
Subjects:
Online Access:https://doi.org/10.1186/s12301-025-00476-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832594609322065920
author Masoomeh Salehi
Behzad Imani
Shirdel Zandi
Hamed Haghiabi
Somayeh Souri
author_facet Masoomeh Salehi
Behzad Imani
Shirdel Zandi
Hamed Haghiabi
Somayeh Souri
author_sort Masoomeh Salehi
collection DOAJ
description Abstract Background Transurethral resection of the prostate (TURP) surgery, as a common surgical technique for cases of benign prostatic hyperplasia, can often lead to various complications during and after the procedure. Among these, intraoperative bleeding and postoperative shivering are highly prevalent. Accordingly, the present study aimed to compare three combinations of tranexamic acid (TXA) dissolved in warm, cold, and room-temperature irrigation fluids to determine their greater effectiveness in reducing bleeding and postoperative complications, such as shivering, following TURP. Methods This prospective, double-blind clinical trial was conducted from April to November 2023 at Imam Khomeini Hospital in Alashtar, Iran. 100 patients scheduled for TURP were selected via convenience sampling and randomly assigned into four groups using a four-block and permutation design. The groups were as follows: Intervention Group A (TXA dissolved in cold irrigation fluid), Intervention Group B (TXA dissolved in room-temperature irrigation fluid), Intervention Group C (TXA dissolved in warm irrigation fluid), and the Control Group (room-temperature irrigation without TXA). Intraoperative bleeding was measured using a photometer, hemoglobin levels were assessed with the Cell-Dyn3200 hematology analyzer, and postoperative shivering was evaluated using the Crossley and Mahajan scale. Results Postoperative bleeding was significantly lower in Intervention Group A compared to the other groups (P < 0.05). Hemoglobin levels decreased significantly over time (P < 0.05), but no significant inter-group differences in hemoglobin changes were observed (P > 0.05). Postoperative shivering was lowest in Intervention Group C and highest in Intervention Group A (P < 0.05). Conclusions Combining TXA in a cold irrigation fluid potentially reduces intraoperative bleeding, but is associated with a higher incidence of postoperative shivering than the other groups.
format Article
id doaj-art-307c68dd132b4a7db8bc5882948ff6d5
institution Kabale University
issn 1961-9987
language English
publishDate 2025-01-01
publisher SpringerOpen
record_format Article
series African Journal of Urology
spelling doaj-art-307c68dd132b4a7db8bc5882948ff6d52025-01-19T12:29:25ZengSpringerOpenAfrican Journal of Urology1961-99872025-01-0131111010.1186/s12301-025-00476-zEffect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trialMasoomeh Salehi0Behzad Imani1Shirdel Zandi2Hamed Haghiabi3Somayeh Souri4Hamadan University of Medical SciencesHamadan University of Medical SciencesHamadan University of Medical SciencesLorestan University of Medical SciencesHamadan University of Medical SciencesAbstract Background Transurethral resection of the prostate (TURP) surgery, as a common surgical technique for cases of benign prostatic hyperplasia, can often lead to various complications during and after the procedure. Among these, intraoperative bleeding and postoperative shivering are highly prevalent. Accordingly, the present study aimed to compare three combinations of tranexamic acid (TXA) dissolved in warm, cold, and room-temperature irrigation fluids to determine their greater effectiveness in reducing bleeding and postoperative complications, such as shivering, following TURP. Methods This prospective, double-blind clinical trial was conducted from April to November 2023 at Imam Khomeini Hospital in Alashtar, Iran. 100 patients scheduled for TURP were selected via convenience sampling and randomly assigned into four groups using a four-block and permutation design. The groups were as follows: Intervention Group A (TXA dissolved in cold irrigation fluid), Intervention Group B (TXA dissolved in room-temperature irrigation fluid), Intervention Group C (TXA dissolved in warm irrigation fluid), and the Control Group (room-temperature irrigation without TXA). Intraoperative bleeding was measured using a photometer, hemoglobin levels were assessed with the Cell-Dyn3200 hematology analyzer, and postoperative shivering was evaluated using the Crossley and Mahajan scale. Results Postoperative bleeding was significantly lower in Intervention Group A compared to the other groups (P < 0.05). Hemoglobin levels decreased significantly over time (P < 0.05), but no significant inter-group differences in hemoglobin changes were observed (P > 0.05). Postoperative shivering was lowest in Intervention Group C and highest in Intervention Group A (P < 0.05). Conclusions Combining TXA in a cold irrigation fluid potentially reduces intraoperative bleeding, but is associated with a higher incidence of postoperative shivering than the other groups.https://doi.org/10.1186/s12301-025-00476-zTURPBleedingShiveringTXAIrrigation fluid
spellingShingle Masoomeh Salehi
Behzad Imani
Shirdel Zandi
Hamed Haghiabi
Somayeh Souri
Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
African Journal of Urology
TURP
Bleeding
Shivering
TXA
Irrigation fluid
title Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
title_full Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
title_fullStr Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
title_full_unstemmed Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
title_short Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial
title_sort effect of tranexamic acid dissolved in warm cold and room temperature irrigation fluid on complications during and after turp surgery a double blind randomized clinical trial
topic TURP
Bleeding
Shivering
TXA
Irrigation fluid
url https://doi.org/10.1186/s12301-025-00476-z
work_keys_str_mv AT masoomehsalehi effectoftranexamicaciddissolvedinwarmcoldandroomtemperatureirrigationfluidoncomplicationsduringandafterturpsurgeryadoubleblindrandomizedclinicaltrial
AT behzadimani effectoftranexamicaciddissolvedinwarmcoldandroomtemperatureirrigationfluidoncomplicationsduringandafterturpsurgeryadoubleblindrandomizedclinicaltrial
AT shirdelzandi effectoftranexamicaciddissolvedinwarmcoldandroomtemperatureirrigationfluidoncomplicationsduringandafterturpsurgeryadoubleblindrandomizedclinicaltrial
AT hamedhaghiabi effectoftranexamicaciddissolvedinwarmcoldandroomtemperatureirrigationfluidoncomplicationsduringandafterturpsurgeryadoubleblindrandomizedclinicaltrial
AT somayehsouri effectoftranexamicaciddissolvedinwarmcoldandroomtemperatureirrigationfluidoncomplicationsduringandafterturpsurgeryadoubleblindrandomizedclinicaltrial