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ORIGINAL ARTICLE
Year : 2021  |  Volume : 32  |  Issue : 3  |  Page : 125-131

Effect of short-term preoperative dutasteride and finasteride on bleeding after transurethral resection of the prostate: A prospective randomized study


Department of Urology, Osmania Medical College, Hyderabad, Telangana, India

Correspondence Address:
Nitesh Kumar
Room No: 504, Old Men's Hostel, Osmania Medical College, Koti, Hyderabad - 500 095, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/UROS.UROS_2_21

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Purpose: Transurethral resection of the prostate (TURP) is the standard surgical treatment for patients with benign prostatic hyperplasia (BPH). Among the many complications of TURP, the most prevalent and serious complication is hemorrhage. The aim of the study was to compare the effect of short-term (2–4 weeks) pretreatment of BPH with dutasteride and finasteride on bleeding after TURP. Methods: A prospective randomized double-blinded study was conducted in Osmania General Hospital, a tertiary care center for a period of 2 years. Two hundred and forty patients who were planned for TURP were included and randomized into four groups; D2: 2 weeks of dutasteride, F2: 2 weeks of finasteride, P2: 2 weeks of placebo, and D4: 4 weeks of dutasteride. The primary outcome was to evaluate the volume of blood loss. Results: The baseline variables were comparable among the groups. Statistically significant differences were seen in total volume of blood loss (183.4 vs. 172.7 vs. 288.5 vs. 173.2 ml, P = 0.01), blood loss per minute of operating time (3.80 vs. 3.65 vs. 5.71 vs. 3.61 ml/min, P = 0.02), and blood loss per gram of resected prostatic tissue (7.61 vs. 7.43 vs. 11.57 vs. 7.21 ml/g, P = 0.008). Blood transfusion requirement was significantly more in the placebo group (11.8%) compared to other groups (P = 0.02). Conclusion: Short-term preoperative dutasteride and finasteride for 2 weeks are equally effective, and they significantly reduce the perioperative blood loss during TURP. Four weeks of dutasteride has no significant advantage when compared to its 2-week course.


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