| Objective: Hemorrhage is a major complication of transurethral prostate resection,often leading to considerable patient anxiety and repeat office or emergency department visits In this study, by pretreated with finasteride for 1 week before surgery and 1-2 weeks after surgery, we evaluate the curative effect of finasteride on decreased bleeding in perioperation of benign prostatic hyperplasia during transurethral resection of prostate. To study the influence of finasteride on microvessel density between prostatic suburethral and nodular hyperplasia. The mechanism of finasteride on decreased bleeding in perioperation of benign prostatic hyperplasia during transurethral resection of prostate was discussed. Materials and Methods: From 2002.5 to 2003.10, a total of 80 patients with clinical BPH who underwent prostate reductive surgery were randomized to 5 mg., 10 mg. finasteride daily or nothing for 1 week before surgery and 2 weeks after surgery. The control group did not receive finasteride or any from of hermone therapy at any time before surgery. The suburethral and hyperplastic prostate was immunohistochemically stained for CD34,VEGF and TGFβ1. A comparative study of clinical data and immunohistochemical parameters was made among the 3 groups. The indication for surgery in each case was BPH with refractory bladder outlet obstructive symptoms. No patient had a history of a recent urinary tract infection or urethral catheterization before surgery. Serum prostate specific antigen was determined in each case before the initiation of finsteride therapy in the treatment group. Transrectal prostate biopsy of the prostate was performed to exclude prostate cancer in any patient with an abnormal digital rectal examination or elevated PSA greater than 4 ng./ml. before surgery. Histological and immunohistochemical testing. At operation surgical specimens that included the prostatic urethra and prostatic hyperplastic nodules were identified and used for histological analysis. Paraffin embedded sections were stained with hematoxylin and eosin. The BPH (epithelial and fibromuscular hyperplasia) was histologically confirmed in each case. No patient in the treatment or control group had histological evidence of prostate cancer. Relevant blocks containing the prostatic urethra as well as nodular hyperplasia were re-sectioned and stained using monoclonal immunohistochemical antibody to CD-34, vascular endothelial growth factor and transforming growth factor beta 1. The microvessel density, resected prostate, the blood loss and blood transfusion in perioperation were calculated. Statistics analysis was performed with the SPSS11.5/PC package. The One-Way ANOVA t test was used to compare statistically mean and maximnm microvessel density in the treatment 1,2 and control groups. The VEGF and TGFβ1 in the treatment 1,2 and control groups was test with χ2 test. The level of statistical significance was set at P<0.05. Results: The blood loss and blood transfusion needed in perioperation were less in two groups treated with finasteride.(P<0.05) The prostatic suburethral microvessel density (P<0.01) and the expression of VEGF (P<0.05)as studied by immunohistochemistry were much less in the finasteride groups. But, the expression of TGFβ1 was increased.(P<0.05) A comparison of patient age and resected prostate weight did not reveal significant differences in the groups. Mean patient age in the treatment 1,2 and control groups wes 70.7±8.7, 64.4±5.7 and 62.1±6.6 years. Mean resected prostate weight in the treatment 1,2 and control groups wes 38.5±5.8, 34.9±5.2 and 26.4±5.3g. Mean blood transfusion in perioperation in the treatment 1,2 and control groups wes 36.4±8.9, 55.7±10.3 and 314.4±55.7ml. Mean blood transfusion in perioperation in the treatment 1,2 groups were significantly lower in the control group. Between the treatment 1,2 groups, there was not significant differences. By typical immunohistochemical staining for CD-34 in the prostate in the treatment 1,2 and c...
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