Tranexamic acid for the management of hematuria: A systematic review

<h3 dir="ltr">Objective</h3><p dir="ltr">To evaluate TXA’s efficacy in managing hematuria and synthesize current evidence to guide urological practice. </p><h3 dir="ltr">Methods</h3><p dir="ltr">This systematic review...

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Main Author: Lina Naseralallah (14146465) (author)
Other Authors: Dima Nasrallah (22225495) (author), Raneem Alsheikh (20644332) (author), Deemah Assami (22225492) (author), Rawan Boudaka (22963528) (author)
Published: 2025
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_version_ 1864513524385972224
author Lina Naseralallah (14146465)
author2 Dima Nasrallah (22225495)
Raneem Alsheikh (20644332)
Deemah Assami (22225492)
Rawan Boudaka (22963528)
author2_role author
author
author
author
author_facet Lina Naseralallah (14146465)
Dima Nasrallah (22225495)
Raneem Alsheikh (20644332)
Deemah Assami (22225492)
Rawan Boudaka (22963528)
author_role author
dc.creator.none.fl_str_mv Lina Naseralallah (14146465)
Dima Nasrallah (22225495)
Raneem Alsheikh (20644332)
Deemah Assami (22225492)
Rawan Boudaka (22963528)
dc.date.none.fl_str_mv 2025-12-26T09:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.urology.2025.12.035
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Tranexamic_acid_for_the_management_of_hematuria_A_systematic_review/31017820
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Tranexamic acid (TXA)
Hematuria
Urology
Antifibrinolytic agents
Postoperative bleeding
dc.title.none.fl_str_mv Tranexamic acid for the management of hematuria: A systematic review
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3 dir="ltr">Objective</h3><p dir="ltr">To evaluate TXA’s efficacy in managing hematuria and synthesize current evidence to guide urological practice. </p><h3 dir="ltr">Methods</h3><p dir="ltr">This systematic review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42022335404). We searched four databases, including PubMed, EMBASE, CINAHL, and Cochrane, for studies on TXA use in adults with hematuria with either interventional or observational designs. Data extraction and quality assessment were performed independently by two reviewers, and findings were summarized using a narrative synthesis. </p><h3 dir="ltr">Results</h3><p dir="ltr">The search yielded 227 records, of which seven studies (970 participants) met inclusion criteria. Four trials on postoperative hematuria showed that tranexamic acid (TXA)—particularly intravenous—consistently reduced hemoglobin decline and blood loss. Three studies on non-postoperative hematuria demonstrated reductions in visible hematuria and symptom duration, though effects on transfusion and laboratory outcomes were variable. All administration routes—intravenous, oral, and intravesical irrigation—were effective; however, IV TXA showed superior outcomes in postoperative cases, while oral and irrigation routes appeared more advantageous in non-surgical settings. </p><h3 dir="ltr">Conclusion</h3><p dir="ltr">TXA is effective in reducing both postoperative and non-postoperative hematuria, supporting its expanded use in urological practice. However, larger, high-quality studies are needed to confirm these findings and refine treatment protocols.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Urology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.urology.2025.12.035" target="_blank">https://dx.doi.org/10.1016/j.urology.2025.12.035</a></p>
eu_rights_str_mv openAccess
id Manara2_37dd61cdc4c0b0739ecb314828c957d7
identifier_str_mv 10.1016/j.urology.2025.12.035
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/31017820
publishDate 2025
repository.mail.fl_str_mv
repository.name.fl_str_mv
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rights_invalid_str_mv CC BY 4.0
spelling Tranexamic acid for the management of hematuria: A systematic reviewLina Naseralallah (14146465)Dima Nasrallah (22225495)Raneem Alsheikh (20644332)Deemah Assami (22225492)Rawan Boudaka (22963528)Biomedical and clinical sciencesClinical sciencesPharmacology and pharmaceutical sciencesTranexamic acid (TXA)HematuriaUrologyAntifibrinolytic agentsPostoperative bleeding<h3 dir="ltr">Objective</h3><p dir="ltr">To evaluate TXA’s efficacy in managing hematuria and synthesize current evidence to guide urological practice. </p><h3 dir="ltr">Methods</h3><p dir="ltr">This systematic review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42022335404). We searched four databases, including PubMed, EMBASE, CINAHL, and Cochrane, for studies on TXA use in adults with hematuria with either interventional or observational designs. Data extraction and quality assessment were performed independently by two reviewers, and findings were summarized using a narrative synthesis. </p><h3 dir="ltr">Results</h3><p dir="ltr">The search yielded 227 records, of which seven studies (970 participants) met inclusion criteria. Four trials on postoperative hematuria showed that tranexamic acid (TXA)—particularly intravenous—consistently reduced hemoglobin decline and blood loss. Three studies on non-postoperative hematuria demonstrated reductions in visible hematuria and symptom duration, though effects on transfusion and laboratory outcomes were variable. All administration routes—intravenous, oral, and intravesical irrigation—were effective; however, IV TXA showed superior outcomes in postoperative cases, while oral and irrigation routes appeared more advantageous in non-surgical settings. </p><h3 dir="ltr">Conclusion</h3><p dir="ltr">TXA is effective in reducing both postoperative and non-postoperative hematuria, supporting its expanded use in urological practice. However, larger, high-quality studies are needed to confirm these findings and refine treatment protocols.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Urology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.urology.2025.12.035" target="_blank">https://dx.doi.org/10.1016/j.urology.2025.12.035</a></p>2025-12-26T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.urology.2025.12.035https://figshare.com/articles/journal_contribution/Tranexamic_acid_for_the_management_of_hematuria_A_systematic_review/31017820CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/310178202025-12-26T09:00:00Z
spellingShingle Tranexamic acid for the management of hematuria: A systematic review
Lina Naseralallah (14146465)
Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Tranexamic acid (TXA)
Hematuria
Urology
Antifibrinolytic agents
Postoperative bleeding
status_str publishedVersion
title Tranexamic acid for the management of hematuria: A systematic review
title_full Tranexamic acid for the management of hematuria: A systematic review
title_fullStr Tranexamic acid for the management of hematuria: A systematic review
title_full_unstemmed Tranexamic acid for the management of hematuria: A systematic review
title_short Tranexamic acid for the management of hematuria: A systematic review
title_sort Tranexamic acid for the management of hematuria: A systematic review
topic Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Tranexamic acid (TXA)
Hematuria
Urology
Antifibrinolytic agents
Postoperative bleeding