Comparison of Perioperative Bleeding in Transurethral Resection of Prostate for Benign Prostatic Hyperplasia with and without Preoperative Dutasteride
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Date
2024-06
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Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: Benign Prostate Hyperplasia (BPH) is characterized by increased proliferation of stromal and acinar cells around the urethra, prolonged by increased gland angiogenesis. The increased vascularity can result in massive bleeding during and after TURP. 5 alpha-reductase inhibitor treatment has been reported to reduce this bleeding. There is conflict regarding use of Dutasteride before surgery to decrease intraoperative blood loss. This study aims to compare the perioperative bleeding in TURP with and without two weeks of preoperative treatment with dutasteride in patients with BPH. Material and Methods: This is a Single-center, Randomized Controlled Open-label Trial done at Department of Urology and Renal Transplant Unit-II, Mayo Hospital Lahore, Pakistan, from February 17, 2018, to February 17, 2019. Patients fulfilling the inclusion criteria of age over 55, unresponsive to medical therapy, and an enlarged prostate (40-70 grams) with an absolute indication for surgery. Group A received a tablet of dutasteride 0.5 mg once a day. Group B did not receive dutasteride two weeks before transurethral resection of the prostate for BPH. Patients were followed up after 24 hours of surgery in which hematocrit levels were estimated. Blood loss was calculated by recording pre-operative and post-operative (after 24 hours) hematocrit levels. Results: 64 patients were randomized into two groups, i.e., Group A (TURP with dutasteride) and Group B (TURP without dutasteride). The mean age was 66.4�5 years in group A and 66.5�2 years in group B. The mean blood loss was 158.3�1.1 ml in group a patients and 311.5�0.7 ml in group B, with a p-value of 0.000054, which is statistically significant. Conclusions: Patients on dutasteride have less perioperative bleeding during transurethral resection of the prostate for BPH than controls.
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Keywords
Transurethral Resection of Prostate, Dutasteride, Benign Prostatic Hyperplasia
Citation
Tiwari Jonesh, BK Mukesh, Bhatta Om Prakash, Daha Sunil Kumar. Comparison of Perioperative Bleeding in Transurethral Resection of Prostate for Benign Prostatic Hyperplasia with and without Preoperative Dutasteride. International Journal of Contemporary Medical Research. 2024 Jun; 11(6): 1-5