Effects of short-term dutasteride and Serenoa repens on perioperative bleeding and microvessel density in patients undergoing transurethral resection of the prostate

Tuncel, Altuğ; Ener, Kemal; Han, Özge; Nalçacıoğlu, Varol; Aydın, Ömür; Seçkin, Selda; Atan, Ali

doi:10.1080/00365590903164498

Cited by 8 publications

(20 citation statements)

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“…The MVD was lower in those who received chlormadinone acetate [4]. Recently, Tuncel et al [16] reported that administration of dutasteride or Serenoa repens did not decrease perioperative blood loss and were not effective in suppression MVD in prostatic tissues.…”

Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Prostat'ın transüretral rezeksiyonundan (TUR-P) önce uygulanan tek doz goserelin' in, benign prostat hiperplazisi (BPH) olan hastalarda kan kaybı ve prostat subüretral dokunun mikrovasküler dansitesi (MVD) üzerine olan etkilerinin belirlenmesi amaçlandı. Gereç ve Yöntem: TUR-P planlanan hastalar iki gruba randomize edilerek ayrıldı. Ameliyattan 1 ay önce 3,6 mg subkütan goserelin asetat uygulanan 18 hasta Grup 1'i oluşturdu. Grup 2 ise goserelin verilmeyen 21 hastadan oluşturuldu. İntraoperatif kanama miktarı ölçüldü.Her hasta için toplam kan kaybı, toplam kan kaybı/ ameliyat süresi, toplam kan kaybı/ rezeke edilen doku gramı hesaplandı. Prostat subüretral doku kesitleri mikrovasküler dansitesi açısından incelendi. Bulgular: Ameliyattan hemen sonra yapılan kontrolde; grup 1'deki hemoglobin (Hb) düşüşü grup 2'ye göre daha fazlaydı ve ortalama Hb seviyesi grup 1'de grup 2'ye kıyasla istatistiksel olarak anlamlı derecede düşük bulundu (p=0.028). İstatistiksel olarak anlamlı olmamasına rağmen irrigasyon sıvısında Hb konsantrasyonu ve ameliyat süresince kan kaybı grup 1'de grup 2'ye oranla daha yüksekti, buna karşılık TUR-P süresine göre ve rezeke edilen prostat doku ağırlığına göre kan kaybı ise grup 1'de grup 2'ye gore daha düşüktü. Mikrovasküler dansite grup 2'de belirgin olarak daha azdı. Tartışma: Bir aylık tek doz goserelin tedavisi, TUR-P boyunca olan kan kaybını azaltmada etkili değildir ve prostat dokusunda mikrovasküler dansitesi üzerinde süpresif etkisi yoktur. Anahtar KelimelerBenign Prostat Hiperplazisi; Goserelin; Mikrovasküler Dansite; Kan Kaybı; Prostatın Transüretral Rezeksiyonu Abstract Aim: To determine the effects of one dose goserelin before transurethral resection of the prostate (TUR-P) on blood loss and microvessel density (MVD) of prostatic suburethral tissues in the patients with benign prostatic hyperplasia (BPH). Material and Method: The patients who planned to have a TUR-P were randomly divided into two groups. Group-1 consisted of 18 patients who were pretreated with 3,6 mgr subcutaneous injection of goserelin acetate one month before the operation. Group-2 was constructed from 21 patients without goserelin acetate pretreatment. The amount of intraoperative haemorrhage was calculated. Total blood loss, total blood loss/duration of surgery and total blood loss/gram of resected tissue were calculated for each patient. Sections from the prostatic suburethral tissues were examined for microvessel density. Results: Quantitative decreases in Hb were greater in group 1 than in group 2, and mean Hb level was statistically significantly lower in group 1 than in group 2 at the control just after the operation (p=0.028). Although all the differences were statistically insignificant, Hb concentration in irrigation fluid and total blood loss during surgery were higher in the group 1 than in the group 2, contrarily, blood loss by duration of TURP and blood loss by weight of resected prostate tissue were less in the group 1 than in the group 2. The MVD was significantly lower in group 2 than ...

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Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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“…18,19 No heterogeneity was detected among the studies (P50.15), and no significant differences were found between the treatment and control groups (P50.98; Figure 3). In the study conducted by Tuncel et al, 20 total blood loss, blood loss/weight and Hb changes did not differ between the treatments and control groups (P50.124, 0.130 and 0.912, respectively). In addition, no difference in blood loss volume between treatment and control groups was found by Bepple et al…”

Section: Mechanisms Of Finasteride Actionmentioning

confidence: 99%

“…Three studies that referred to MVD were identified. [19][20][21] In the studies conducted by Tuncel et al…”

Section: (P5014)mentioning

confidence: 99%

“…[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). The results of this meta-analysis suggest that preoperative treatment with finasteride for 2-4 weeks could decrease bleeding during transurethral resection for BPH, possibly because finasteride appears to decrease MVD of prostate tissue.…”

mentioning

confidence: 99%

“…[18][19][20][21][22] The goal of the present study was to perform a meta-analysis to evaluate the effects of finasteride and dutasteride on intraoperative bleeding during transurethral management of BPH, which will resolve some of the remaining controversies over the use of these drugs.…”

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confidence: 99%

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

Zong

Peng²,

Yang³

et al. 2011

Asian J Androl

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1 5a-reductase inhibitors (5a-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Many studies reported that preoperative 5a-RI had impact on intraoperative haemorrhage during surgery for BPH, but it was still in controversial. So, we conducted a systematic review of the effects and mechanisms of 5a-RIs on intraoperative bleeding for BPH. MEDLINE, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials and the reference lists of retrieved studies were searched in the analysis. Sixteen publications involving 15 different randomized controlled trials (RCTs) and a total of 1156 patients were used in the analysis, including 10 RCTs for finasteride and five RCTs for dutasteride. We found that preoperative finasteride treatment decreases microvessel density (MVD) in resected prostate specimens. Total blood loss, blood loss per gram of resected prostate tissue and decreases in haemoglobin were all greatly reduced in the finasteride group as compared to controls. Dutasteride appeared to have no effect on bleeding. This meta-analysis shows that preoperative finasteride treatment could decrease intraoperative haemorrhage during surgery for BPH. Preoperative dutasteride had no effect on intraoperative haemorrhage, but further high-quality prospective studies are still needed to confirm this observation. Asian Journal of Andrology (2011) 13, 812-818; doi:10.1038/aja.2011.86; published online 5 September 2011Keywords: 5a-reductase inhibitor; benign prostate hyperplasia; haemorrhage; meta-analysis; microvessel density INTRODUCTION 5a-reductase inhibitors (5a-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Finasteride, a type II 5a-RI, blocks the conversion of testosterone to dihydrotestosterone. Inhibition of 5a-reductase reduces the concentration of dihydrotestosterone in the prostate, which results in a decreased volume of the prostate, improved urinary flow and a decline in the incidence of acute urinary retention and the need for surgery.

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Efecto en el sangrado perioperatorio durante la resección transuretral de la próstata tras un mes de tratamiento con dutasteride

Arratia-Maqueo

Garza-Cortés

Gómez‐Guerra

et al. 2010

Actas Urológicas Españolas

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Effects of short-term dutasteride and Serenoa repens on perioperative bleeding and microvessel density in patients undergoing transurethral resection of the prostate

Cited by 8 publications

References 0 publications

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

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

Efecto en el sangrado perioperatorio durante la resección transuretral de la próstata tras un mes de tratamiento con dutasteride

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