Impact of preoperative administration of finasteride on perioperative bleeding during transurethral vapor resection of the prostate

Abstract

We investigated whether finasteride given before transurethral vapor resection (TUVRP) treatment has an impact on intra- and postoperative bleeding. Forty-two patients with diagnosis of benign prostatic hyperplasia (BPH) who had prostate volume (PV) > 30 mL underwent TUVRP: group A (n=21) received preoperatively finasteride 5 mg per day for median time of 7 months and group B (n=21) no finasteride. Preoperative evaluation include assessment of International Prostatic Symptom score (IPSS ), Quality of Life (QoL), PV, maximum flow rate (Qmax) and postvoid residual (PVR). Patients mean age was 71.4± 2.1 vs 69.8 vs ± 3.4 years, respectively. Median PV was 55.5 ±21.2 vs 57.1 ±28.8 mL, respectively. Twenty-two (52%) patients had complete retention (29% vs 76%) (p<0.001). At baseline mean IPSS , QoL, Qmax and PVR were 18.1±5.9 vs 19.8±5.04, 3.3±1.7 vs 3.3±1.7, 8.1±4.4 vs 6.9±1.6 mL/s, and 146±106.9 vs 151.6±112.1 mL, respectively. The mean operation time was 59±16.8 vs 64±19.2 min, mean volume of irrigation fluid intraoperatively was 14.1±7.01 vs 15.2±8.1 L and postoperatively 7.0±2.1 vs 8.1 ±1.3 L, respectively. Mean blood loss was 312±85.9 vs 425±68.5 mL, respectively. The mean weight of resected tissue was 31.3±5.8 vs 30.75±8.4 gr, respectively. Mean duration of postoperative irrigation was 6.1 ± 4.7 vs 6.2 ±5.1 h, respectively. Thirty-six (85.7%) patients were discharged within 12 h postoperatively and the catheter is removed on 2.0±0.5 vs 2.5 ± 0.6 days, respectively. No patients received blood transfusion postoperatively. At 3 months postoperatively IPSS was 6.7±4.2 vs 5.2 ±2.01 (p<0.001), QoL 1.1±0.9 vs 1.1±0.7, Qmax 18.1±10.3 vs 17.5±8.1 mL/s (p<0.01) and PVR 41±46.1 vs 45±51.3 mL (p<0.05). The present study failed to demonstrate that preoperative treatment of BPH with finasteride did not have significant impact of perioperative bleeding at TUVRP.