Intravesical Tranexamic Acid for Patients Requiring Continuous Bladder Irrigation in the ED: A Non-Randomized Feasibility Study

Abstract

Objectives Tranexamic Acid (TXA) is a well studied clot stabilizer that may have benefit when used intravesically prior to continuous bladder irrigation (CBI). This study determined the feasibility of conducting a randomized controlled trial using TXA intravesically in patients who present to the emergency department (ED). The study goals were to recruit 20 participants within a six-month time frame and have an 80% recruitment rate. Methods Potential participants were identified at triage if they presented with a complaint of hematuria or urinary retention and were over the age of eighteen. Informed consent was obtained if the patient needed CBI and met inclusion/exclusion criteria. If consented, TXA was instilled intravesically at the start of CBI treatment and the patient was followed until their CBI treatment was complete. Results A total of 14 (out of 18) participants were recruited over eight months. The mean age of participants was 74.5 +/- 7.4 years with only one of the 14 participants identifying as female. For resource management, the study was designed to include support from an on-call nurse. The on-call nurse was called seven out of fourteen times and came into hospital one time. Eight participants did not require hospital admission after the TXA intervention. The mean length of hospital stay for participants was 4.6+/-2.7 days. The mean ED length of stay was 8.1+/-4.9 hours. There were no reported adverse events. Conclusion The recruitment rate of 78% indicated that the study was acceptable to participants, but we were unable to meet our goal of recruiting 20 participants over six months. Study protocol was followed, and no adverse events were found.