A Randomized, Controlled Trial of Pretreatment with Finasteride in Patients with Benign Prostate Hyperplasia Undergoing Transurethral Resection of the Prostate: Its Effects on Perioperative Bleeding and Microvessel Density

A Randomized, Controlled Trial of Pretreatment with Finasteride in Patients with Benign Prostate Hyperplasia Undergoing Transurethral Resection of the Prostate: Its Effects on Perioperative Bleeding and Microvessel Density
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Title:A Randomized, Controlled Trial of Pretreatment with Finasteride in Patients with Benign Prostate Hyperplasia Undergoing Transurethral Resection of the Prostate: Its Effects on Perioperative Bleeding and Microvessel Density
Author/Abstract:
Anthony Laurence Escovidal, MD; Jose B. Wenceslao, MD; Jaime C. Balingit, MD; Ponciano M. Bernardo Jr., MD

Department of Urology, East Avenue Medical Center


Objectives: (1) To evaluate the expression of prostatic microvessel density in patients with benign prostatic hyperplasia (BPH) treated with finasteride among Filipino patients. (2) To evaluate the effects of finasteride in perioperative bleeding in patients undergoing transurethral resection of prostate for BPH. Materials and Methods: Twenty (20) patients scheduled to undergo transurethral prostatic surgery for benign disease were randomized to pretreatment of finasteride 5 mg tablet once a day for 2 weeks before surgery. Perioperative bleeding parameters include serum hemoglobin determination one day before surgery and immediately 6 hours after the surgery and day 1 post-op. Parraffin blocks were sent for special immunohistochemical von Willebrand factor (factor 8) staining and microvessel density were analyzed. Results: There was a significant difference in the mean decrease in serum hemoglobin level from the preoperative level to that measured in the immediate postoperative recovery period (4.2 + 2.30 gm/dL vs 7.4 + 3.63 gm/dL). However, there was no significant difference in the mean decrease in pre-operative serum hemoglobin level compared with the level measured one day after the procedure (8.9 + 8.01 gm/dL vs. 15.20 + 10.04 gm/dL). There was significantly less hemoglobin in the irrigation fluid in the finsteride group than in the control group (1.28 + 1.38 vs 7.92 + 6.34). Mean microvascular density in the finasteride group was 58.00 + 2.50 and in controls, 71.00 + 31.07. Conclusion: Pretreatment with Finasteride 5 mg given daily for 2 weeks in patients with BPH undergoing TURP significantly decreases perioperative bleeding. Finasteride administration also decreases microvessel density in prostatic tissue.

Key words: finasteride, transurethral resection of prostate
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