Transurethral Resection of Prostate and the Role of Pharmacological Treatment with Dutasteride in Decreasing Surgical Blood Loss

Pastore, Antonio Luigi; Mariani, Simone; Barrese, Francesco; Palleschi, Giovanni; Valentini, Armando Manuel; Pacini, Luca; Petrozza, Vincenzo; Carbone, Antonio; Cappa, Manlio

doi:10.1089/end.2012.0231

Cited by 34 publications

(44 citation statements)

References 8 publications

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“…Five studies were retrospective cohort studies (LE: 2b) [23][24][25][26][27] , and 5 RCTs (LE: 2a) [14-16, 21, 22] . The methodological quality of these studies was relatively high for one of the RCTs (Jadad scale: 4 of 5 points) [16] and medium for 4 (Jadad scale: 3 of 5 points) [14,15,21,22] . In terms of the 5 non-randomized studies, the quality was relatively high (NOS: 7 of 9 points).…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

“…Ten relevant studies [14][15][16][21][22][23][24][25][26][27] were selected for analysis including 1,022 patients in total (521 treated with dutasteride and 501 in the control group). No differences were found in terms of age and the basic physical conditions between the treatment group and control group.…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

“…Hb Alteration Five studies [16,[22][23][24]27] evaluated the changes of Hb level before and after TURP. One trial [22] was excluded due to the lack of SD values.…”

Section: Meta-analysismentioning

confidence: 99%

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

Ren

Lai²,

Jiang³

et al. 2016

Urol Int

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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.

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Section: Assessment Of Study Qualitymentioning

confidence: 99%

Section: Assessment Of Study Qualitymentioning

confidence: 99%

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

Ren

Lai²,

Jiang³

et al. 2016

Urol Int

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“…5-ARIs block the conversion of testosterone to dihydrotestosterone, reducing the activity of androgen-controlled growth factors responsible for angiogenesis. [8] This feature was tested for effectiveness in the prevention of intraoperative bleeding in patients undergoing transurethral resection of the prostate. Some studies have supported the pharmacological use of 5-ARIs to reduce surgical blood loss.…”

Section: Discussionmentioning

confidence: 99%

“…[6] With the aid of this effect, dutasteride has been shown to reduce perioperative bleeding rates in patients undergoing transurethral resection. [7,8] However, to the best of our knowledge, there is no published study regarding the effect of dutasteride on reducing perioperative bleeding in patients undergoing OP. In this study, we aimed to evaluate whether pretreatment with dutasteride can reduce perioperative bleeding rates in patients undergoing OP.…”

Section: Introductionmentioning

confidence: 99%

Effect of dutasteride treatment on reducing blood loss and in perioperative period of open prostatectomy

Gökçe¹,

Kerimov²,

Akıncı³

et al. 2015

Turkish Journal of Urology

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Objective: Open prostatectomy (OP) is a valid option for the surgical treatment of large prostates in the absence of holmium laser enucleation. The most frequent complication of OP is intra-and perioperative bleeding. Preoperative use of dutasteride has been shown to reduce vascularity and perioperative bleeding in transurethral resection of the prostate (TUR-P). However, there has been no study addresing this effect in OP. The aim of this study was to evaluate whether pretreatment with dutasteride for 6 weeks before OP can reduce surgical blood loss. Material and methods:Data of 218 patients with benign prostatic hyperplasia (BPH) who underwent OP was investigated retrospectively. Of the 218 patients, 46 were treated with dutasteride for at least 6 weeks and the rest were dutasteride naïve. Age, prostate volume, prostate-specific antigen (PSA) levels, coagulation tests, platelet counts, pre-and postoperative hemoglobin (Hb) levels, and transfusion history were recorded. Blood loss was estimated as follows: preoperative Hb (-) postoperative Hb (+) amount of transfusion. The 2 groups were compared by independent samples t-test and a p value of 0.05 was considered significant. Results:The groups were similar in terms of age, prostate volume, platelet counts, coagulation tests, and postoperative Hb levels. Preoperative Hb levels were lower in the dutasteride group (13.4 vs. 14.3, p=0.002) and amount of bleeding (-2.72 g/dL vs. -1.93 g/dL, p= 0.01) was shown to be significantly lower in dutasteride group. Conclusion:Our results showed that pretreatment with dutasteride for 6 weeks before OP considerably reduces perioperative surgical bleeding. Further prospective randomized trials should be conducted to confirm the effectiveness of such treatment.

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Effects of Steroidal Antiandrogen or 5-alpha-reductase Inhibitor on Prostate Tissue Hormone Content

et al. 2017

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Transurethral Resection of Prostate and the Role of Pharmacological Treatment with Dutasteride in Decreasing Surgical Blood Loss

Abstract: Our results showed that pretreatment with dutasteride for 6 weeks before TURP reduces the surgical bleeding considerably. This treatment schedule can be used routinely to decrease TURP surgical bleeding.

Cited by 34 publications

References 8 publications

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

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

Effect of dutasteride treatment on reducing blood loss and in perioperative period of open prostatectomy

Effects of Steroidal Antiandrogen or 5-alpha-reductase Inhibitor on Prostate Tissue Hormone Content

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