(219) THE IMPACT OF TRANEXAMIC ACID ON HEMOGLOBIN LEVELS AND OPERATING TIME IN AQUABLATION FOR BENIGN PROSTATIC HYPERPLASIA: PRELIMINARY RESULTS FROM A RETROSPECTIVE CASE–CONTROL STUDY

Abstract Introduction Benign prostatic hyperplasia (BPH) is the leading cause of lower urinary tract symptoms in men. While transurethral resection of the prostate (TURP) has been the standard surgical intervention, new techniques like Aquablation are becoming more common. Aquablation utilizes a resective waterjet which avoids thermal tissue damage but has little coagulative effect during the active treatment cycle, and heat directed coagulation cannot be performed. Tranexamic acid (TXA) is known for its antifibrinolytic properties and is used in many surgeries to minimize perioperative blood loss. However, its effects on outcomes of Aquablation has not yet been studied. Objective The objective of this study is to determine whether the administration of TXA at the start of the Aquablation procedure reduces perioperative blood loss and impacts operating time, as evidenced by changes in hemoglobin levels and operating time. Methods We reviewed the cases of 20 patients who underwent Aquablation performed by a single surgeon (J.H.) between August 2022 and June 2024. Ten patients received TXA during the procedure (TXA group), and ten did not (non-TXA group). Patients were matched based on age, prostate size, and use of anticoagulants or antiplatelets. Preoperative hemoglobin (pre-Hgb) was recorded within 25 days before surgery, and postoperative hemoglobin (post-Hgb) was recorded on postoperative day 1 (POD1). Operating time was also documented. Statistical analyses included paired and independent t-tests to compare changes in Hgb and operating time between groups. Analyses were performed using SPSS 29 (IBM Corp., Armonk, NY). Results The TXA group showed a significantly smaller reduction in hemoglobin levels (mean change -0.51) compared to the non-TXA group (mean change -1.65), with a t-value of 2.58 and a p-value of 0.025. There was no significant difference in mean operating time between the TXA (52.3 minutes) and non-TXA (52.2 minutes) groups (p = 0.966). Conclusions Preliminary results suggest that TXA use in Aquablation for BPH is associated with a significantly smaller reduction in hemoglobin levels, indicating less blood loss during the waterjet resection portion of the case. There was no significant impact on operating time. These findings contribute to the ongoing study on the benefits of TXA in urologic surgeries. Future research with larger sample sizes and randomized controlled trials is necessary to validate these results. Disclosure No.