Researchers at Tanta University, Egypt, report that goserelin acetate, a drug inducing the luteinising hormone-releasing hormone, reduces blood loss during transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH).
Blood loss during prostate surgery using traditional TURP is a main cause of complications, despite improvement in surgical techniques. Researchers believe that abnormal blood vessel development in an enlarged prostate contributes to the extensive bleeding — a situation aggravated by the blood vessel growth-promoting actions of testosterone.
Drugs called 5a reductase inhibitors (5ARIs), commonly used for enlarged prostates, decrease bleeding during surgery, and researchers suspect this might be a consequence of the drug’s ability to block dihydrotestosterone, leading to a lower rate of new blood vessel formation.
In contrast to 5ARIs, drugs stimulating the luteinising hormone-releasing hormone can block all male sex hormones, and goserelin acetate actually induces a temporary chemical castration. The research team figured that this broader action might further enhance the prevention of blood vessel growth in the prostate, and reduce bleeding during surgery.
The study, “Goserelin acetate before transurethral resection of moderately enlarged benign prostatic hyperplasia: Prospective randomised-controlled clinical trial,“ enrolled 68 BPH patients, and 35 received a single injection of goserelin acetate four weeks before surgery.
Findings, published in the Arab Journal of Urology, showed both a shorter surgery duration and lower blood loss in the patients given goserelin acetate prior to TURP. These patients also had more tissue removed during the procedure, which the researchers speculated might be the result of a clearer, less bloody operative field.
Analyzing prostate tissue removed from two different locations, researchers also noted that the treated group had a lower density of small blood vessels, indicating that, in addition to dihydrotestosterone, other sex hormones might contribute to the increased growth of blood vessels in the prostate.
Patients reported tolerable side effects, and only four, or 11.4 percent, reported adverse effects that were not related to the depletion of sex hormones. The study did not report on how long these side effects were present following surgery.
More studies in patients with bigger prostates or higher risk profiles might help to establish a treatment to significantly reduce blood loss during TURP.