To evaluate the effects of short term use of finasteride and dutasteride on the amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia (BPH) prior to transurethral resection of prostate (TURP).
The study involved 450 male patients who planned to have TURP and were prospectively randomized into 3 groups (150 patients each). Group 1 received placebo, group 2 received finasteride 5 mg/day and group 3 received dutasteride 0.5 mg/day for 4 weeks before the operation. The total blood loss, requirement of blood, and prostatic stromal and suburethral tissues MVDs were recorded for each patient and compared among the 3 groups.
There were significantly less mean blood loss, blood loss/time, total blood loss/weight of resected tissue in the finasteride and dutasteride group than in the placebo group. Prostatic and suburethral MVDs were significantly greater in the placebo group. Blood transfusion was required in 9.3%, 2.7%, and 2% of the patients, respectively (p=0.004). However, no significant statistical differences were found between the finasteride and dutasteride groups for any of these variables (p >0.05). The mean operating time, weight of resected prostate tissue group, and the amount of irrigation fluid showed no significant differences among the 3 groups.
Short-term pretreatment with finasteride and dutasteride has similar efficacy and significantly reduces perioperative bleeding during TURP and has minimal negative impact on sexual function. According to our findings, a 4 weeks' prior administration of 5-ARIs may reduce operative blood loss and prostatic MVD in TURP, thus potentially decreasing blood loss- related complications and the requirement of blood transfusion.
Journal of endourology. 2017 Jan 11 [Epub ahead of print]
Ankur Bansal, Aditi Arora
Janak Surgicare Centre, Patiala, Punjab, India, patiala, Punjab, India ; ., Janak Surgicare Centre, Patiala, Punjab, India, patiala, Punjab, India ; .