Abstract
Background: Dutasteride has been found to reduce chronic prostatic bleeding and when taken 2 - 6 weeks preoperatively reduces bleeding during transurethral prostate resection. The aim of this study is to determine if the drug will be effective in the control of acute gross prostatic haematuria. Patients and Method: 87 Consecutive patients with gross haematuria were enrolled. Clotting Profile, Cystoscopy and Intravenous Urography were done to exclude haematuria from medical, renal and bladder causes. Patients suspected to have prostatic haematuria were further evaluated using serum Prostate specific antigen (PSA) and Prostate scan. Those with elevated PSA ≥ 10 ng/ml and abnormal digital rectal examination (DRE) finding had prostate biopsy. The patients were randomly divided into 2 treatment groups. The control group had Normal saline irrigation and broad spectrum antibiotics while the second group received 0.5 mg oral dutasteride in addition. The time taken and volume of irrigation fluid used before haematuria stopped were noted. Statistical analysis was done using SPSS version 20.0. Result: 75 patients had haematuria of prostatic origin. 49 (65.3%) of these had benign prostatic hyperplasia (BPH) and 26 (34.7%) had cancer of prostate. 25(51%) of the 49 patients with BPH had Normal saline irrigation and antibiotics while 24 (49%) had oral dutasteride in addition. 14 (53.8%) of the prostate cancer patients had Normal saline irrigation and antibiotics while 12 (46.2%) had dutasteride in addition. Haematuria resolved in significantly shorter length of time using lesser volume of irrigation fluid in those treated with dutasteride than in those on control arm. Conclusion: Addition of 0.5 mg oral dutasteride daily leads to early resolution of acute prostatic haematuria.
Highlights
Haematuria resolved in significantly shorter length of time using lesser volume of irrigation fluid in those treated with dutasteride than in those on control arm
Addition of 0.5 mg oral dutasteride daily leads to early resolution of acute prostatic haematuria
Haematuria caused by benign prostatic hyperplasia or adenocarcinoma of the prostate is a common clinical condition and may account for up to 27% and 8% of cases of gross haematuria respectively [1]
Summary
Haematuria caused by benign prostatic hyperplasia or adenocarcinoma of the prostate is a common clinical condition and may account for up to 27% and 8% of cases of gross haematuria respectively [1]. Intervention with a 5 alpha reductase inhibitor such as dutasteride is a method that safely deprives the prostate of DHT, the primary growth stimulus This causes prostate gland shrinkage, relieves lower urinary tract symptoms, and lowers the risk of disease progression and complications [7] [8]. Removal of DHT through the activity of dutasteride or other 5α reductase inhibitors prevents angiogenesis and reduces prostatic blood flow and vascular density [10]. These various mechanisms are thought to be the reasons why dutasteride and finasteride have been used successfully to reduce chronic or long standing prostatic bleeding and for reduction of prostate size. The aim of this study is to evaluate the effectiveness of dutasteride in the treatment of acute gross prostatic haematuria caused by benign prostatic hyperplasia or cancer of the prostate
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