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 JBM  Vol.7 No.5 , May 2019
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 significant lower mean blood loss was observed in the dutasteride group compared to the control group. Conclusion: Preoperative dutasteride therapy reduces blood loss related to TURP in patients with BPH. This therapy can be practiced to reduce surgical bleeding associated with TURP.
Cite this paper: Rahman, M. , Johura, F. , Rasul, M. , Bhuiyan, A. , Ali, M. , Hossain, M. , Islam, M. , Rahman, A. and Ashrafee, F. (2019) Effect of Preoperative Dutasteride on Bleeding Related to Transurethral Resection of Prostate in Patients with Benign Prostatic Hyperplasia. Journal of Biosciences and Medicines, 7, 157-169. doi: 10.4236/jbm.2019.75017.
References

[1]   Rassweiler, J., Teber, D., Kuntz, R. and Hofmann, R. (2005) Complications of Transurethral Resection of the Prostate (TURP)—Incidence, Management, and Prevention. European Urology, 50, 969-980.
https://doi.org/10.1016/j.eururo.2005.12.042

[2]   Kim, K.S., Jeong, W.S., Sung, Y.P., Yong, T.K. and Hong S.M. (2015) The Effect of Two Weeks of Treatment with Dutasteride on Bleeding after Transurethral Resection of the Prostate. The World Journal of Men’s Health, 33, 14-19.
https://doi.org/10.5534/wjmh.2015.33.1.14

[3]   Jamal, A., Nivasarao, P.S., Rajan, L.R. and Kumar. S. (2016) Is Transurethral Resection of Prostate Made Safer by Preoperative Dutasteride Therapy? A Randomized Controlled Trial. International Journal of Contemporary Medical Research, 3, 43-50.

[4]   Kravchick, S., Cytron, S., Mamonov, A., Peled, R. and Linov, L. (2009) Effect of Short-Term Dutasteride Therapy on Prostate Vascularity in Patients with Benign Prostatic Hyperplasia: A Pilot Study. Urology, 73, 1274-1278.
https://doi.org/10.1016/j.urology.2008.08.461

[5]   Miller, J. and Tarter, T.H. (2007) Update on the Use of Dutasteride in the Management of Benign Prostatic Hypertrophy. Clinical Interventions in Aging, 2, 99-104.

[6]   Zong, H.T., Peng, X.X., Yang, C.C. and Zhang, Y. (2011) A Systematic Review of the Effects and Mechanisms of Preoperative 5α-Reductase Inhibitors on Intraoperative Hemorrhage during Surgery for Benign Prostatic Hyperplasia. Asian Journal of Andrology, 13, 812-818.
https://doi.org/10.1038/aja.2011.86

[7]   Hahn, R.G., Fagerstrom, T., Tammela, T.L., Trip, O.V. and Beisland, H.O. (2007) Blood Loss and Postoperative Complications Associated with Transurethral Resection of the Prostate after Pretreatment with Dutasteride. BJU International, 99, 587-594.
https://doi.org/10.1111/j.1464-410X.2006.06619.x

[8]   Gokce, M.I., Kerimov, S., Akinci, A., Hamidi, N., Afandiyev, F. and Yaman, O. (2015) Effect of Dutasteride Treatment on Reducing Blood Loss and in the Perioperative Period of Open Prostatectomy. Turkish Journal of Urology, 41, 24-26.
https://doi.org/10.5152/tud.2015.90094

[9]   Ren, J., Shi, C.L., Zhao, Q.J., et al. (2016) A Systematic Review and Meta-Analysis of the Effects on Dutasteride Treatment for Reducing Surgical Blood Loss during Transurethral Resection of the Prostate. Urologia Internationalis, 98, 456-465.
https://doi.org/10.1159/000453669

[10]   Zhu, Y.P., Dai, B., Zhang, H.L., Shi, G. and Ye, D.W. (2015) Impact of Preoperative 5α-Reductase Inhibitors on Peri-operative Blood Loss in Patients with Benign Prostatic Hyperplasia: A Meta-Analysis of Randomized Controlled Trials. BMC Urology, 15, Article ID: 2204.
https://doi.org/10.1186/s12894-015-0043-4

[11]   Zaitsu, M., Tonooka, A., Mikami, K., Hattori, M., Takeshima, Y. and Uekusa, T. (2013) A Dual 5α-Reductase Inhibitor Dutasteride Caused Reductions in Vascular Density and Area in Benign Prostatic Hyperplasia. ISRN Urology, 2013, Article ID: 863489.
https://doi.org/10.1155/2013/863489

[12]   Shanmugasundaram, R., Singh, J.C. and Kekre, N.S. (2007) Does Dutasteride Reduce Perioperative Blood Loss and Postoperative Complications after Transurethral Resection of the Prostate? Indian Journal of Urology?, 23, 334-335.

[13]   Hagerty, J.A., Ginsberg, P.C., Harmon, J.D. and Harkaway, R.C. (2000) Pretreatment with Finasteride Decreases Perioperative Bleeding Associated with Transurethral Resection of Prostate. Urology, 55, 684-689.
https://doi.org/10.1016/S0090-4295(00)00454-4

[14]   American Urological Association (2010) Guideline on the Management of Benign Prostatic Hyperplasia (BPH). American Urological Association Education and Research, Inc.

[15]   Boccon-Gibod, L., Valton, M., Ibrahim, H. and Comenducci, A. (2005) Effect of Dutasteride on the Reduction of Intraoperative Bleeding Related to Transurethral Resection of Prostate. Progrès en Urologie, 15, 1085-1089.

[16]   Busetto, G.M., Gabriele, A., Riccardo, G. (2013) 1601 Dutasteride Can Reduce Intraoperative Bleeding During Transurethral Resection of the Prostate: Evaluation of Vascular Endothelial Growth Factor (VEGF) and CD34. The Journal of Urology, 189, 658.
https://doi.org/10.1016/j.juro.2013.02.3151

[17]   Moon, H.S., Choi, H.Y., Park, H.Y. and Kim, Y.T. (2013) Effect of Treatment with Dutasteride on Transurethral Resection of the Prostate.
https://www.ics.org

[18]   Donohue, J.F., Hayne, D., Karnik, U., Thomas, D.R. and Foster, M.C. (2005) Randomized, Placebo-Controlled Trial Showing that Finasteride Reduces Prostatic Vascularity Rapidly within 2 Weeks. BJU International, 96, 1319-1322.
https://doi.org/10.1111/j.1464-410X.2005.05849.x

[19]   Martov, A.G. and Ergacov, D.V. (2008) The Experience in Dutasteride Use before Transurethral Prostatic Resection for Large Adenoma. Urologiia, 46, 48-52.

[20]   Pastore, A.L., Mariani, S., Barrese, F., Palleschi, G., Valentini, A.M., Pacini, L., et al. (2013) Transurethral Resection of Prostate and the Role of Pharmacological Treatment with Dutasteride in Decreasing Surgical Blood Loss. Journal of Endourology, 27, 68-70.
https://doi.org/10.1089/end.2012.0231

[21]   Arratia-Maqueo, J.A., Garza-Cortés, R., Gómez-Guerra L.S. and Cortés-González J.R. (2010) Effect of One Month Treatment with Dutasteride on Transurethral Resection of the Prostate. Actas Urológicas Espanolas, 34, 866-869.
https://doi.org/10.1016/j.acuro.2010.06.005

 
 
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