EFFECT OF DUTASTERIDE IN DECREASING SURGICAL BLOOD LOSS FOLLOWING UNIPOLAR TRANSURETHRAL RESECTION OF PROSTATEIN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA: A QUASI EXPERIMENTAL STUDY

Abstract

Objective: To observe the effect of dutasteridein decreasing surgical blood loss following unipolar transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH).

Study Design: Quasi experimental study.

Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Jul 2017 to Mar 2018.

Methodology: 66 BPH patients were consecutively reunited. Six patients declined participation while 4 wereexcluded because of chronic kidney disease and/or a bleeding disorder. The included patients underwent an evaluation for hematocrit, serum urea and creatinine, and international normalized ratio. Four patients with impaired renal functions or altered coagulation parameters were also excluded. Patients taking non-steroidal antiinflammatory drugs and anticoagulant/antiplatelet drugs discontinued these drugs two weeks prior to TURP. After block randomization,the control group was given tablet tamsulosin hydrochloride 0.4 mg once daily while the target group was provided tablet tamsulosin hydrochloride 0.4 mg and dutasteride 0.5 mg orally once daily. All patients started the drugs two weeks before the operation. TURP was carried out under spinal anesthesia. At 48 h after TURP, a blood sample was revaluated for hematocrit. The resected prostatic tissue was measured.

Results: The mean age of the patients was 68.3 ± 8.4 (range: 50-90 years). The mean hematocrit before operation was 0.42% ± 0.04% (range: 0.31%-0.53%) while themean hematocrit after the operation was 0.38% ± 0.04% (range: 0.28%-0.47%). The mean prostatic tissue removed during TURP was 22.3 ± 11.6 g (range: 7-54 g). The mean hematocrit reduction was 0.05% ± 0.02% (range: 0.1%-0.02%) and the mean hematocrit reduction per gram of prostatic tissue removed was 547.2 ± 355.1%/g (range: 1666.7%/g – 100%/g). After statistical analysis, there was no significant difference for the mean reduction in hematocrit (p=0.59).

Conclusion: Dutasteride at a dose of 0.4 mg per day did not produce significant reduction in relative blood loss and relative blood loss per gram of prostatic tissue removed with 2-weeks pretreatment before unipolar TURP in patients with BPH.