The effect of two weeks of treatment with dutasteride on bleeding after transurethral resection of the prostate

摘要

Purpose: Dutasteride affects the prostate by reducing intraprostatic dihydrotestosterone and prostate tissue vascularity. We evaluated the effect of pretreatment with dutasteride for two weeks on perioperative and postoperative bleeding during transurethral resection of the prostate (TURP). Materials and Methods: Eighty-three patients who had benign prostatic hyperplasia together with the criteria for eligibility for TURP were included. The dutasteride group consisted of 40 patients who were treated with dutasteride (0.5 mg/d) for two weeks before surgery, and the control group consisted of 43 patients who did not receive dutasteride. Blood loss was evaluated in terms of reduction in serum hemoglobin (Hb) and hematocrit (Hct) levels, which were measured before, immediately after, and 24 hours after surgery. We also measured the durations of indwelling urethral catheter use, continuous saline bladder irrigation, and hospitalization. Results: Lower mean blood loss was observed in the dutasteride group than the control group immediately after and 24 hours after surgery (Delta Hb = 0.65 +/- 1.27 g/dL vs. 1.16 +/- 0.73 g/dL, 1.30 +/- 1.00 g/dL vs. 1.86 +/- 1.05 g/dL respectively, p = 0.019, p = 0.011;. Delta Hct = 1.89% +/- 3.83% vs. 3.47% +/- 2.09%, 3.69% +/- 2.95% vs. 5.39% +/- 3.23% respectively, p = 0.016, p = 0.011). In addition, there were fewer days of indwelling urethral catheter use (2.95 +/- 1.02 d vs. 3.92 +/- 1.14 d, p = 0.000), continuous saline bladder irrigation (1.81 +/- 1.08 d vs. 2.36 +/- 1.06 d, p = 0.016), and hospitalization after TURP (3.95 +/- 1.09 d vs. 4.76 +/- 1.19 d, p = 0.001) in the dutasteride group. Conclusions: Preoperative treatment with dutasteride for two weeks before TURP reduces surgical bleeding and length of hospitalization after TURP. This pretreatment can be used to decrease surgical bleeding associated with TURP.