Tranexamic Acid Reduces Major Bleeding in Urologic Surgery

Perioperative hemorrhage remains a frequent complication in urologic practice, particularly during high-volume procedures such as transurethral resection of the prostate and percutaneous nephrolithotomy [1, 2]. While tranexamic acid is established as a standard of care for reducing transfusion requirements in cardiac and orthopedic surgery, its application in urology has historically been limited by concerns over potential thrombotic risks [3, 4]. Previous meta-analyses have suggested that this antifibrinolytic agent, which inhibits the breakdown of fibrin clots, may reduce blood loss in specific urologic contexts, yet the evidence base has consisted largely of small, heterogeneous trials [5, 6]. Consequently, major clinical guidelines have remained silent on its routine use, leaving a significant gap in standardized protocols for patients at high risk of bleeding [7]. A large-scale international trial now provides the necessary clarity on the safety and efficacy of this intervention across a broad urologic population.