Effect of Preoperative Dutasteride on Bleeding Related to Transurethral Resection of Prostate in Patients with Benign Prostatic Hyperplasia

Abstract

Background: Transurethral resection of prostate (TURP) is the gold standard in the surgical treatment of symptomatic benign prostatic hyperplasia (BPH). Blood loss is one of the most common complications of TURP. Objective: To evaluate the effect of preoperative dutasteride on bleeding related to TURP in patients with BPH. Materials and Methods: This prospective interventional study was done in the department of urology, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period of July 2016 to June 2017. A total of 70 cases of BPH planned for TURP were included in this study according to the statistical calculation. Patients were randomly allocated to control group A (TURP without dutasteride) and dutasteride group B (TURP with dutasteride). Each group consisted of 35 patients. Group B patients were treated with dutasteride 0.5 mg/day for 4 weeks before TURP. The main outcome of blood loss was evaluated in terms of reduction in serum hemoglobin (Hb) and hematocrit (Hct) levels, which were measured before and 24 hours after surgery. Data were analyzed and compared by statistical tests. Results: Comparison of outcome between groups shows that there was a significant difference in term of pre-post operative change of hemoglobin and hematocrit levels in the control group A compared to the dutasteride group B (Hb = 2.96 ± 0.80 gm/dl vs. 1.81 ± 0.71 gm/dl, respectively, p = 0.001; Hct = 11.20% ± 2.12% vs. 6.07% ± 2.02%, respectively, p = 0.02

A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

“…The rich blood flow in the prostate gland and the high intraoperative bleeding are risks of conventional TURP (25). This study found that blood loss after TUSP was significantly lower in BPH patients with a prostate volume less than 50 mL than those with more than 50 mL.…”

The role of preoperative dutasteride in reducing bleeding during transurethral resection of the prostate: A systematic review and meta-analysis of randomized controlled trials

“…An initial 516 titles and abstracts were screened, of which 32 studies were accessed for full-text eligibility. In all, 11 were included for meta-analysis [ 19 , 20 , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] ]. Table 1 presented the summary of the included studies, while Fig.…”

“…Six studies (775 samples) from both treatment ( n =387) and control ( n =388) groups reported the Hb level alteration before and after the procedure [ [25] , [26] , [27] , [29] , [30] , [31] ]. Pooled analysis showed a significant lower reduction of Hb level in group receiving dutasteride as compared with control (MD −1.10, 95% CI −1.39 to −0.81, p <0.00001).…”

“…[ 30 ] 2018 RCT Dutasteride Placebo 30 30 NA 0.5 4 NA Unspecified TURP NA NA Hb change Rahman et al. [ 31 ] 2019 RCT Dutasteride Placebo 35 35 65.4 0.5 4 62.5 Unspecified TURP 2.69 3.20 Operation time and Hb change Khoso et al. [ 23 ] 2019 RCT Dutasteride Placebo 26 26 68.3 0.5 2 NA Monopolar TURP NA NA Blood loss RCT, randomized controlled trial; TURP, transurethral resection of the prostate; MVD, microvessel density; Hb, haemoglobin; NA, not available.…”

Transparent Hose Has the Advantages of Reducing Surgical Trauma and Complications in the Treatment of Benign Prostatic Hyperplasia Patients with Bladder Stones

“…If intraoperative insertion, exit, rotation of the mirror sheath caused some damage to the urethra, increase the risk of surgery [10] . If the lithotripsy time is prolonged, it is easy to cause bladder mucosa edema and brittleness, which increases the risk of intraoperative bladder perforation and postoperative infection [11] . In particular, for patients with cardiopulmonary basic diseases, the extension of operation time will increase the risk of operation.…”