Tranexamic Acid Shows Promise in Reducing Bleeding During Urologic Surgery

At the European Association of Urology annual congress, new findings from the POISE-3 trial showed that tranexamic acid (TXA) can significantly reduce major bleeding in patients undergoing urologic surgery. In a subgroup of over 1,100 patients, major bleeding occurred in 6.1% of those receiving TXA compared to 9.5% in the placebo group, representing a meaningful risk reduction. However, there were no significant differences in broader 30-day efficacy or safety outcomes, including severe bleeding events or cardiovascular complications.

TXA’s benefits were largely linked to reduced need for blood transfusions, although the difference in transfusion rates between groups was not statistically significant. Experts highlighted that perioperative bleeding remains a major issue in urologic procedures, especially in open oncologic surgeries, despite advances such as robotic techniques.

Importantly, TXA was found to be safe, with no clear increase in risks such as stroke or venous thromboembolism, though the study was not powered to fully assess these outcomes. While previous studies across surgical fields have shown mixed results, this analysis supports considering TXA as part of perioperative care, particularly in high-risk urologic patients, due to its low cost, accessibility, and ease of use.

Bassett, M. (2026, March 17). Tranexamic acid reduces major bleeding in urologic surgery. MedPage Today. https://www.medpagetoday.com/meetingcoverage/eau/120347