Patients pretreated with the drug dutasteride for two weeks before prostate surgery show lower levels of blood loss and improved postoperative recovery, according to the recent study “The Effect of Two Weeks of Treatment with Dutasteride on Bleeding after Transurethral Resection of the Prostate” published in The World Journal of Men’s Health.
Transurethral resection of the prostate (TURP) is the gold standard of surgical treatment for patients with benign prostatic hyperplasia (BPH) who fail to respond to drug treatments. The safety and efficacy of this surgical method is largely validated. However, as an invasive procedure it may lead to adverse side effects, including perioperative bleeding, urinary incontinence, retrograde ejaculation, transurethral resection syndrome, and erectile dysfunction.
A non-malignant enlargement of the prostatic tissue causes BPH, and dihydrotestosterone (DHT) is the primary male hormone responsible for this proliferation in elderly men.
Researchers tested the effect of the dual 5-α-reductase inhibitor (5-ARI) dutasteride, when administered for two weeks before transurethral resection of the prostate, in reducing perioperative and postoperative bleeding, and improving postoperative care. (Dutasteride is a drug approved for the treatment of BPH by reducing intraprostatic dihydrotestosterone and prostate tissue vascularity.)
They enrolled 83 patients with BPH set to undergo TURP and divided them into two groups, with 40 patients pretreated with dutasteride (0.5 mg/d) for two weeks and 43 patients serving as controls. Blood hemoglobin and hematocrit levels were measured before, immediately after, and 24 hours after surgery to assess blood loss in each group of patients. The impact of dutasteride therapy on postoperative care was determined by measuring several parameters, including durations of indwelling urethral catheter use, continuous saline bladder irrigation, and hospitalization.
They observed that patients pretreated with dutasteride exhibited a lower mean blood loss when compared to controls, immediately after and 24 hours after surgery. Moreover, postoperative care parameters were also shorter, specifically the indwelling urethral catheter use, continuous saline bladder irrigation, and hospitalization in the dutasteride group.
In conclusion, these results support using dutasteride as a pretreatment for reducing surgical bleeding associated with transurethral resection of the prostate.