Six weeks finasteride monotherapy before TURP: Does it improve quality of life in early post operative period?

Abstract

IntroductionBenign prostatic hyperplasia (BPH) is a common disease affecting men 50 years and older. Treatment options consist of observation, pharmacological treatment, minimally invasive surgery and traditional surgery. Alpha-blockers and 5-alpha-reductase inhibitors are the primary medications used to treat BPH. Transurethral resection of the prostate (TURP) is the gold standard of surgical management of BPH. ObjectiveTo evaluate the effect of six weeks finasteride therapy before TURP on overall surgical outcomes and early postoperative quality of life (QoL). Patients and methodsBetween June 2014 and August 2016, patients with BPH at our department were randomly assigned to one of two groups: group (A) receiving 5 mg of finasteride daily for six weeks and group (B) did not receiving finasteride before TURP. All patients were assessed using a modified validated Arabic version of the International Prostate Symptom Score (IPSS). Intra operative serum hemoglobin concentration and hemoglobin concentration in irrigating fluid were recorded. One month post-surgery, IPSS, storage, voiding subscores and QoL scores were measured. ResultsOut of a total of 115 patients, 98 patients completed the study. Before surgery, there was no significant difference between the two groups in prostate size (Prostate size was 54.52 ± 7.3 g in group A and 50.19 ± 6.8 g in group B, p value = 0.72), IPSS (19.86 ± 4.68 in group A vs. 21.14 ± 4.33 in group B, p value = 0.17), maximum urinary flow rate and post-void residual urine test results. No significant difference between Qol score in both groups before surgery (p value = 0.96). Group A patients had significantly less intraoperative blood loss than group B patients (308.29 ± 48.1 ml vs. 431.11 ± 96.4 ml, p = 0.001). One month postoperatively, group A patients showed greater improvement in QoL than group B patients (p = 0.03). ConclusionsFinasteride therapy for 6 weeks before TURP reduced intraoperative blood loss and statistically improved quality of life in the early postoperative period. However, larger number of patients and longer duration of follow up is recommended to confirm its clinical significance.