Effect of Pre-operative Finasteride Therapy on Perioperative Blood Loss in Transurethral Resection of Prostate for Benign Prostatic Hyperplasia-A Prospective Randomized Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 9
Abstract
Background: Benign prostatic hyperplasia (BPH) is the common benign tumor in men more than 50 years of age. 5α-reductase inhibitors such as finasteride and dutasteride are commonly used in the medical management of BPH due to its prostatic volume reduction properties secondary to inhibition of the androgen dihydrotestosterone. Studies have reported that short course of pre-operative finasteride reduces perioperative blood loss following transurethral resection of prostate (TURP) for BPH. However, this is not practiced widely. Therefore, we conducted this study to evaluate the effect of finasteride on intraoperative and post-operative blood loss following TURP, which could resolve some of the controversies over the use of this drug. Materials and Methods: One hundred patients undergoing TURP for BPH were randomly allocated into two groups with 50 patients in each group. Group A patients received tablet finasteride 5 mg once a day 2 weeks before surgery and Group B patients received only placebo. Intraoperative blood loss, post-operative hemoglobin (HB), packed cell volume drops and operative time, resected tissue weight and tissue microvessel density (MVD) were assessed. Post-operative follow-up was done at 1 month maximum urinary flow rate and international prostate symptom score score was assessed. Results: The demographic parameters were comparable in two groups. The mean HB drop in Groups A and B was 1.7 and 2.8 g, respectively. The mean operative time and resected tissue weight in both Groups A and B were 46 min, 27.7 g and 53 min, 24.1 g, respectively. In finasteride group, there was a significant reduction of intraoperative blood loss, MVD, and post-operative complications such as clot retention, need for blood transfusion, and urinary tract infection. Conclusion: Pre-operative short course finasteride therapy definitely reduces the perioperative blood loss following TURP for BPH.
Authors and Affiliations
T Chandru, R Neelakandan, K Natarajan
Keywords
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