Researchers at the Hanyang University College of Medicine in Seoul have conducted a study indicating that treatment with dutasteride prior to transurethral resection of the prostate reduces bleeding and hospitalization time following surgery. The research study, entitled “The Effect of Two Weeks of Treatment with Dutasteride on Bleeding after Transurethral Resection of the Prostate,” was published in The World Journal of Men’s Health.
Transurethral resection of the prostate (TURP) is the standard surgical procedure used in benign prostatic hyperplasia (BPH) patients who do not respond to non-surgical treatments. It is a safe and effective procedure for prostate enlargement that involves the removal of prostate tissue through the urethra. However, it is associated with some complications, namely bleeding, urinary incontinence and erectile dysfunction, overall decreasing patients’ quality of life.
BPH is the result of extended proliferation of smooth muscle and epithelial cells due to the effect of an androgen hormone (dihydrotestosterone). This hormone is synthesized from testosterone through the action of enzymes, called 5-α-reductases, which are active in the prostrate and also contribute to tissue vascularization. Drugs that inhibit these specific enzymes, such as finasteride and dutasteride, are used in the treatment of BPH and have been found to reduce complications of blood loss following surgery.
To test the effectiveness of dutasteride in reducing such bleeding, researchers treated 40 patients with the drug for two weeks before TURP, and compared their post-operative profile with that of 43 patients who did not receive dutasteride pre-surgery. The parameters evaluated were blood loss, measured by serum hemoglobin (Hb) and hematocrit (Hct) levels before, immediately after, and 24 hours after surgery, duration of indwelling (fixation) urethral catheter use, continuous saline irrigation, and hospitalization. The results showed that those patients who received dutasteride had lower blood loss levels and higher Hb and Hct values immediately and, again, 24 hours after surgery when compared to the control group. Moreover, those treated with the inhibitor drug had fewer days of indwelling urethral catheter use, steady saline bladder irrigation and hospitalization after TURP.
The results show dutasteride as a promising preoperative treatment to reduce post-TURP surgical bleeding, although researchers highlight the need for longer studies with larger numbers of patients.