ReviewCanadian Urological Association journal = Journal de l'Association des urologues du Canada2026
The efficacy and safety of tranexamic acid use during radical cystectomy A systematic review and meta-analysis.
Review in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRadical cystectomy (RC) is the standard treatment for muscle-invasive bladder cancer (MIBC), but it is associated with substantial perioperative blood loss and high transfusion rates. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated efficacy in reducing surgical blood loss across various specialties; however, due to a paucity of randomized controlled trials in the RC setting, its role remains uncertain. We conducted a systematic review and meta-analyses to synthesize the current evidence and provide a critical assessment of TXA use during RC.
methodsStudies evaluating TXA during RC were identified through a comprehensive search of multiple databases up to November 2024. Primary outcomes included intraoperative and perioperative blood transfusion rates and estimated blood loss (EBL). The secondary outcome assessed was thromboembolic events.
resultsFive studies comprising 1736 patients were included. TXA did not significantly reduce EBL (mean deviation [MD] -85.56 mL; 95% confidence interval [CI] -191.13-20.02, p>0.05) or intraoperative transfusion rates (odds ratio [OR] 0.73, 95% CI 0.40-1.33, p>0.05); however, TXA was associated with a lower likelihood of perioperative transfusions (OR 0.56, 95% CI 0.32-0.97, p<0.05). Notably, TXA increased the risk of thromboembolic events (OR 2.05, 95% CI 1.15-4.65, p<0.05). Heterogeneity varied across analyses, with robotic-assisted RC underrepresented in the included studies.
conclusionsThis systematic review and meta-analysis revealed that, in patients undergoing RC, the use of TXA does not significantly reduce EBL or intraoperative transfusion rates. Moreover, TXA appears to be associated with an increased incidence of thromboembolic events, suggesting a potential prothrombotic effect. Based on these findings, its routine use in this context cannot be recommended, particularly when intended to reduce thromboembolic risk.
Identifiers
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Registered trials
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