Study Of Finasteride On Intraoperative Bleeding During Prostate Operation And Postoperative Hematuria

Objective: 1 Moderate or severe Benign prostatic hyperplasia is mainly treated by operation in our country. But intraoperative bleeding and hematuria after operation is an important factor which affects the effect of operation and increases mortality . Some literature reported that pre-surgical finasteride(5 alpha-reductase inhibitor) therapy will limit intraoperative bleeding in patients undergoing transurethral resection of the prostate (TURP), but sample is small, and it is not done on open prostatectomy . Its dosage,time and mechanism are not made certain . In Our study we mainly aimed to demonstrate the efficacy of short-term treatment with finasteride limiting intraoperative bleeding and postoperative hematuria in patients undergoing transurethral resection of the prostate (TUR-P) and open prostatectomy . 2 The prostate volume is one important index of estimating prostatic diseases and effect of treatment, and we usually choose treatment method by it. We will measure the shape and volume of prostate by the technique of three dimensional (3D) CT reconstruction.Method: Forty patients with benign prostatic hyperplasia undergoing TURP and forty patients undergoing open prostatectom were randomly divided into two groups: 20 patients were treated with 5mg. finasteride daily for 14 days before surgery and 3 months after surgery , and 20 patients without treatment. Then we divide the patients into two groups according their prostate volume measured by 3D-CT: ≤40ml and >40ml. All patients were followed for 3 months. We looked at the results whether there was no statistically significant difference between the finasteride group and control group regarding mean operating times , the amount of introperative bleeding, and hematuria after operation . Results: All patients could succeed in completing the operation .In thegroup that prostate volume was lager than 40ml, the introperative blood loss, and hematuria after operation in patients treated with finastende were significantly less than those in patients without treatment (P<0.05). But in the group that prostate volume was not lager than 40ml, there was no statistically significant difference between the finasteride group and control group. The prostate volume measured by transabdominal ultrasound (TAUS) was larger than by 3D-CT.Conclusion: 1 Two weeks of finasteride pretreatment and 3 months of finasteride posttreatment provid a significant decrease in intraoperative bleeding and hematuria after operation in patients undergoing transurethral resection of the prostate (TUR-P) and open prostatectomy without any major side effects. It is an simple,safe and effective method, especially in the group that prostate volume was lager than 40ml. 2 The measurement of prostate volume by 3D-CT is more accuracy. The shape and around connection was more intuitionistic. It will help urologist choose treatment method and explain to patient.