Effect of Finasteride Treatment on Suburethral Prostatic Microvessel Density in Patients with Hematuria Related to Benign Prostate Hyperplasia

Abstract

Introduction: In the present study we evaluated the effect of short-term finasteride treatment on microvessel density (MVD)which is an indicator of prostatic angiogenesis in patients with hematuria secondary to benign prostatic hyperplasia (BPH). Materials and Methods: 30 patients who were candidates for BPH surgery were prospectively included in the study. All patients had history of gross hematuria and evaluated by ultrasonography and cystoscopy. The patients were randomized two groups before surgery. The treatment group consisted of 13 patients who were given 5 mg finasteride daily for 4 weeks before surgery. The control group consisted of 17 patients who did not receive finasteride before surgery. During surgery, resected suburethral and hyperplastic prostate specimens were sent for histopathologic MVD determination separately. Results: Mean MVD in the suburethral portion of prostate was significantly lower in patients treated with finasteride when compared with controls (9.08 ± 5.6 and 13.94 ± 5.90, respectively, p < 0.05). Mean MVD for the hyperplastic portion of prostate was similar for the finasteride and control groups (14.21 ± 7.10 and 19.75 ± 9.73, respectively, p > 0.05). Conclusion: The potential role of finasteride on hematuria related to BPH may be the suppressive effect on MVDin the suburethral tissue of prostate.

A systematic review of the effects and mechanisms of preoperative 5α-reductase inhibitors on intraoperative haemorrhage during surgery for benign prostatic hyperplasia

“…Publication bias may influence the results because negative data are less likely to be published. However, some of the published papers that we consulted contained negative results, [11][12][13]15 and our funnel plot does not provide any evidence of publication bias. Our results from the Egger's and Macaskill's tests also confirms that there has been no publication bias (P50.7586 and P50.5240, respectively; Table 1).…”

“…However, only four of these seven studies presented SD values 6,[13][14][15] and were included in the meta-analysis (Figure 2). In three experiments, the MVD of the resected prostate tissue was lower in the treatment group than in the control group; 6,14,15 no differences were found in the remaining one study.…”

“…In three experiments, the MVD of the resected prostate tissue was lower in the treatment group than in the control group; 6,14,15 no differences were found in the remaining one study. 13 Overall, 222 participants (109 in the treatment group and 113 controls) were included in the meta-analysis. Heterogeneity did not exist among the studies (P50.04), so a random-effects model was chosen.…”

“…3,4 However, the ability of finasteride to decrease blood loss during surgical interventions for BPH and its mechanisms of action remain controversial. [5][6][7][8][9][10][11][12][13][14][15] Although one meta-analysis focused on the effects of preoperative finasteride on reducing bleeding during transurethral resection of prostate (TURP), 16 the number of experiments included was insufficient and the underlying mechanisms for these treatment effects were not considered.…”

“…The ability of preoperative finasteride to decrease blood loss has been observed in many studies, [5][6][7][8][9][10] but these effects are not found in all RCTs. [11][12][13][14][15] For example, in the study conducted by Boccon-Gibod et al, 18 preoperative treatment with dutasteride decreased bleeding during treatment for BPH, but these findings were not consistent across studies. [19][20][21][22] Our meta-analysis reviewed 15 contemporary RCTs involving 1156 participants (580 who were treated with 5a-RIs and 576 patients in the control group).…”