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

Kloping, Yudhistira Pradnyan; Yogiswara, Niwanda; Azmi, Yusuf

doi:10.1016/j.ajur.2021.05.011

Cited by 7 publications

(4 citation statements)

References 42 publications

(81 reference statements)

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“…Haematuria is the most common symptom, associated with symptoms of irritation when urinating. Mucusuria may also occur in some patients (1,8,9). In this case, a 29-year-old male came to the hospital with pain in the symphysis pubic area and hematuria.…”

Section: Discussionmentioning

confidence: 94%

Mucinous Adenocarcinoma (Signet Ring Cell Carcinoma) of the Urinary Bladder in Young Male: A Case Report

et al. 2022

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Primary mucinous adenocarcinoma of the urinary bladder is a rare malignancy and accounts for less than 2 % of all malignant urinary bladder tumors. This malignancy occurs more commonly in males, with a peak incidence in the sixth decade of life. Herein, we report a case of a 29-year-old male presenting with pain in the symphysis pubis, urinary frequency, and haematuria. Clinical, laboratory, and radiology findings lead to suspicion of urinary bladder malignancy with bilateral hydronephrosis and chronic kidney disease.

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Section: Discussionmentioning

confidence: 94%

Mucinous Adenocarcinoma (Signet Ring Cell Carcinoma) of the Urinary Bladder in Young Male: A Case Report

et al. 2022

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“…To minimize the blood loss, alpha-blockers and five α inhibitors (5-ARIs) have been used as the primary treatment for large-sized prostates before surgery. The major purpose of these drugs is to lower the level of active testosterone, dihydrotestosterone (DHT), minimizing the blood loss by reducing the prostate size 12,13,14 .…”

Section: Discussionmentioning

confidence: 99%

Intra-Prostatic Injection of Epinephrine during Transurethral Resection of Prostate Reduces Blood Loss and Need for Blood Transfusions

Zohaib¹,

Siddiq²,

Khalid³

et al. 2023

PJMHS

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Aim: To assess the role of Intraprostatic injection of epinephrine intra-operatively in patients undergoing TURP in decreasing blood loss and the need for subsequent blood transfusions. Design: A double-blind, randomized controlled trial. Place and duration of study: The Kidney Centre Postgraduate Training Institute, Karachi, from March till August 2020. Methodology: A total of 40 patients were chosen at random and divided into two groups of equal size. One group got an intra-prostatic injection of epinephrine, whereas the other received a standard saline injection. Both groups were evaluated in terms of prostate volume (ml), resected tissue (gms), surgical resection time (minutes), pre and post-operative Hemoglobin (HB), and Hematocrit (HCT) levels. Intra-operative blood loss was then quantified using the last two variables. Transfusion requirement in both groups was also recorded. Results: Mean +Age of patients in Group A and Group B was 66.30+9.24years and 65.65+7.43years, respectively, with no significant difference between both groups (p=0.808). Median and IQR Prostatic volume in Group A and Group B was 68.0, 15, and 64.0,21, suggesting no statistically significant difference between the two groups (p=0.372). Mean + S.D Loss of HB of patients in Group A and Group B was 1.15 + 0.42 and 1.87+1.04, respectively, with a significant difference between both groups (p=0.007). Mean + S.D of post-op HCT patients in Group A and Group B was 3.16+1.50 and 4.81+2.79, revealing a significant difference between the two groups (p=0.026). No patients in Group A needed blood transfusions, whereas six patients in Group B had blood transfusions, indicating a statistical distinction between the two groups (p=0.001). Conclusion: The use of intra-prostatic injection of epinephrine leads to reduced blood loss and subsequently reduced operative time, irrigation fluid usage, and blood transfusion during TURP. It also allows a greater amount of prostatic tissue to be resected. Keywords: Transurethral resection of Prostate, Epinephrine, Blood transfusion, Hemoglobin, Hematocrit.

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“…Surgical management is recommended to patients with refractory LUTS, recurrent urinary tract infections, recurrent bladder stones or gross haematuria with bladder outlet obstruction, persistent urinary retention secondary to BPH or high-pressure retention (23,30). Prospective 5-ARI administration before TURP has been indicated to reduce the level of surgical bleeding (31). There are also associated decreases in transfusion rates and operating times.…”

Section: Benign Prostatic Hyperplasiamentioning

confidence: 99%

5-alpha reductase inhibitors use in prostatic disease and beyond

Chislett¹,

Chen²,

Perera³

et al. 2023

Transl Androl Urol

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in use today (1,2). Their effect relies on the inhibition of the 5-alpha reductase (5α-reductase) enzyme which aids in the conversion of testosterone to dihydrotestosterone (DHT) (3).Since its introduction, the clinical indication for 5-ARIs has grown from BPH to include androgenetic alopecia (AGA) and hirsutism (1). As more pathological processes are identified as being mediated by DHT, the clinical

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

Cited by 7 publications

References 42 publications

Mucinous Adenocarcinoma (Signet Ring Cell Carcinoma) of the Urinary Bladder in Young Male: A Case Report

Mucinous Adenocarcinoma (Signet Ring Cell Carcinoma) of the Urinary Bladder in Young Male: A Case Report

Intra-Prostatic Injection of Epinephrine during Transurethral Resection of Prostate Reduces Blood Loss and Need for Blood Transfusions

5-alpha reductase inhibitors use in prostatic disease and beyond

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