Does finasteride affect blood loss during monopolar transurethral resection of the prostate?

Objectives To evaluate the effect of preoperative finasteride on the surgical blood loss during monopolar transurethral resection of the prostate (TURP). BackgroundBenign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms in elder men. Prophylactic measures have been employed to reduce perioperative bleeding, including preoperative 5α-reductase inhibitors administration. Finasteride and dutasteride can block the conversion of testosterone to dihydrotestosterone and have been used to treat BPH and BPH-related hematuria.Patients and methodsWe conducted a randomized controlled study at the Urology Department of Menoufia University Hospital, comparing the preoperative use of finasteride 5 mg over the intraoperative bleeding during TURP. A total of 90 patients with BPH with prostate size varying between 40 and 90 g assigned for a monopolar TURP surgery were randomly allocated into three groups: the first group as control, the second group used finasteride 5 mg for 2 weeks before surgery, and the third group used finasteride 5 mg for 4 weeks before surgery.ResultsThere was an insignificant difference between the three groups regarding age or associated comorbidities. Calculated blood loss was lower for the second and third groups in comparison with the control one (P = 0.046).ConclusionResults of our study elicit that treatment with finasteride for even 2 weeks before surgery significantly reduces surgical bleeding.