Transurethral Resection of Prostate and Bleeding: a Prospective Randomized, Double Blind, Placebo Controlled Trial to See Efficacy of Short Term Use of Finasteride and Dutasteride on Operative Blood Loss and Prostatic Micro-Vessel Density

To evaluate the effects of short term use of finasteride and dutasteride on amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in patients with benign prostatic hyperplasia (BPH) prior to TURP METHODS: The study involved 450 male patients who planned to have TURP and were prospectively randomised into three groups (150 patients each).

The group 1 received no medication, 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, prostatic stromal and suburethral tissues microvessel density (MVD) were recorded for each patient and compared between three groups RESULTS: There was significantly less blood loss, blood loss/time, total blood loss/weight of resected tissue in the finasteride and dutasteride group than in control group. Prostatic and suburethral MVD was significantly more in the control group. Blood transfusion was required in 9.3%, 2.7% and 2% patients, respectively (p=0.004). However, no significant statistical differences were found between the finasteride and dutasteride group for any of these variables (p >0.05). Mean operating time, weight of resected prostate tissue group and amount of irrigation fluid showed no significant difference between three groups.

Short-term pre-treatment with finasteride and dutasteride have similar efficacy and significantly reduces perioperative bleeding during TURP. According to our findings, a 4 weeks' prior administration of 5-alpha reductase enzyme inhibitors may reduce operative blood loss and prostatic MVD in the TURP, thus potentially decreasing the blood loss related complications.

Urology. 2016 Nov 15 [Epub ahead of print]

Aditi Arora, Ankur Bansal, Bimalesh Purkait, Ashok Kumar Sokhal, Ved Bhaskar, Priyank Yadav, Satyanarayan Sankhwar

Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India., Department of Urology, King George Medical College, Lucknow, Uttar Pradesh, India. Electronic address: ., Department of Urology, King George Medical College, Lucknow, Uttar Pradesh, India., Department of Urology and Renal Transplant, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

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