A Systematic Review and Meta-Analysis of the Effects on Dutasteride Treatment for Reducing Surgical Blood Loss during Transurethral Resection of the Prostate

Abstract

Objective: This systematic review and meta-analysis were performed to evaluate the efficacy of preoperative dutasteride treatment for reducing surgical blood loss in patients undergoing transurethral resection of the prostate (TURP). Methods: A systematic search was performed from the electronic databases including PubMed, EMBASE, and Cochrane Library by May 2016. We followed the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis statement when examining the literature. Identified articles were strictly appraised for quality and relevance. Results: Five randomized controlled trials (RCTs) and 5 retrospective cohort studies involving 1,022 patients with benign prostate hyperplasia were analyzed based on the inclusion criteria. Pooled analysis revealed that preoperative treatment with dutasteride had a significantly smaller decrease in hemoglobin (weighted mean difference [WMD] -0.47, 95% CI -0.70 to -0.24, p < 0.0001) and hematocrit levels (WMD -1.03, 95% CI -1.73 to -0.33, p = 0.004); However, no significant difference has been found in terms of the total blood loss during TURP and blood loos per gram of resected prostatic tissue, the weight of resected prostate tissue, the microvessel density of the prostate, and the transfusion rate between the dutasteride and the control group. Conclusions: This systematic review and meta-analysis indicate that preoperative treatment with dutasteride could reduce surgical bleeding during TURP, but the findings of this study should be further confirmed by well-designed prospective RCTs with a larger patient series.

Preoperative Dutasteride Use has no effect on Intraoperative Bleeding during Transvesical Open Simple Prostatectomy for Benign Prostatic Hyperplasia

“…However, they found that the mechanism of dutasteride in reducing blood loss is different from finasteride and dutasteride may present a time-dependent manner in reducing the MVD of the prostate. While some authors suggested 6 weeks of treatment is needed to reduce the MVD, some reported that 2 -8 weeks of dutasteride treatment has a limited effect on MVD [8]. In the present study, the lower bound of dutasteride use was 6 weeks.…”

The Consistency Testing and Improving of A Hematuria Colorimetric Card

“…Nowadays, most clinical nurses still estimate the color of the drainage uid based on their subjective evaluation, but there is individual difference existing among them with big deviation, unscienti c and inaccurate which may affect clinical outcomes depending on each nurse's clinical experience and skill level. In addition, some medical personnel calculate the amount of blood loss based on the red blood cell counting, hemoglobin concentration in the drainage uid or the formula to calculate the amount of blood loss [3][4][5], This way with more accurate, however, none has been widely adopted in general practice because requiring more time, more energy and increasing hospitalization costs. There are also some nursing scholars using self-made hematuria colorimetric card when assessing the degree of the hematuria, they have achieved certain success in evaluating postoperative gross hematuria , such as, using this hematuria colorimetric card can reduce anxiety levels of patients and their families and improve effective communication between doctors and nurses because they have a uni ed language [6].…”

Dose Dutasteride Reduce Surgical Blood Loss for Benign Prostatic Hyperplasia Patients? More Information Is Needed

“…Ren et al [1] included both randomized controlled trials (RCTs) and retrospective studies in this meta-anal-…”

“…With great interest, I read the metaanalysis by Ren et al [1] about dutasteride treatment before transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH) patients, which was published recently. In the meta-analysis, Ren et al [1] conclude that "preoperative treatment with dutasteride could reduce surgical bleeding during TURP."…”

“…In the meta-analysis, Ren et al [1] conclude that "preoperative treatment with dutasteride could reduce surgical bleeding during TURP." Though significant for clinical decision, I have some concerns about it, especially for the conclusion.…”