Effect of Preoperative Administration of Dutasteride on Reducing Blood Loss in Perioperative Period of Transurethral Resection of Prostate

Abstract

Abstract
Background and Objective: Clinical benign prostatic hyperplasia (BPH), a condition that commonly occurs in
aging men. It is characterized by the development of lower urinary tract symptoms (LUTS), which can lead to
impairment of bladderfunction and potentialrenal complications.TURPisthe gold standard surgical treatment
of BPH. Dutasteride is a 5-reductase and is used for medical management. This study was planned to
ascertain the effect of pre-treatment dutasteride in reducing blood loss in patients undergoing transurethral
resection of prostate (TURP).
Methods: It was a randomized clinical trial carried out at Department of Urology, Jinnah Hospital Lahore in
which the total study sample was divided in two groups. One group received dutasteride and the second group
was the control group. The study variables were Haemoglobin and Hematocrit values, clotting profile PTand
INR, serum Ca levels and uric acid, BMI, prostate volume, residual volume of urine and hospital stay. Results
were presented as mean ± SD or frequency (%). The main study outcome variable was mean blood loss
(calculated by change in hemoglobin and hematocrit level).
Results: 6 (10.3 %) patients needed blood transfusion in dutasteride group and 7 (12 %) in control group
(p=0.14). Post-surgery change in haemoglobin and HCT levels were less in dutasteride groups as compared
to the control group (ΔHb 1.94±1.27 g/dLvs. 2.16±0.73 g/dL, respectively, p=0.02;ΔHct 5.68 % ± 2.56% vs.
6.52 % ± 2.39 %, respectively, p = 0.04).
Conclusion: Thepresentresearchsuggeststhat administeringDutasteride fourweekspriortotheTURPprocedure
resultsinadecreaseinbloodlossduringtheperi-operativeperiod,ultimatelyleadingtoimprovedpatientoutcomes.
Key words: Benign Prostatic Hyperplasia (BPH). Transurethral resection of Prostate (TURP), 5 Alpha
Reductase Inhibitor (5-ARI)