You are here

Prostatın Transüretral Rezeksiyonu Sırasındaki Kan Kaybının Azaltılmasında Finasterıd’in Rolü

The Role of Finasteride For Decreasing Blood Loss During Transurethral Resection of Prostate

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
In this prospective, randomized study, we aimed to evaluate the efficacy of presurgical finasteride therapy in decreasing perioperative bleeding during transurethral resection of the prostate (TUR-P). A total of 60 patients scheduled to undergo elective transurethral prostate resection were included in the to study. Randomly selected 30 patients received 5 mg finasteride for 2 weeks before surgery while another 30 did not receive any pretreatment. Blood hemoglobin was measured before and after the surgery. The volume and hemoglobin concentration of irrigation fluid, resected prostate weight and duration of resection were recorded. No statisticaliy significant differences were found between the two groups for patient age, PSA level, resected tissue volume and duration of resection. The mean hemoglobin concentration in the irrigation fluid was significantly lower in the finasteride group, than the control group (p=0.017). When the blood loss per gram of resected prostate tissue calculated, the mean difference was more significant (p=0.005). This study shows that preoperative finasteride administration for 2 weeks decreases bleeding in patients undergoing transurethral prostate resection.
Abstract (Original Language): 
Bu randomize prospektif çalışmada; transüretral prostat rezeksiyonundaki (TUR-P) peroperatif kanamanın azaltılmasında, preoperatif finasterid tedavisinin etkinliğini değerlendirmeyi amaçladık. Elektif TUR-P uygulanması planlanan 60 hasta çalışmaya alındı. Bu hastaların, rastgele 30 tanesine cerrahi öncesi tedavi verilmezken, 30 tanesine 2 hafta 5 mg/gün finasterid verildi. Cerrahi öncesi ve sonrası kan hemoglobin düzeyleri ölçüldü. Kullanılan yıkama sıvısının miktarı, hemoglobin konsantrasyonu, rezeksiyon süresi ve rezeke edilen prostat doku ağırlığı kaydedildi. Her iki grup arasında yaş, prostat spesifik antijen (PSA) düzeyi, rezeke edilen doku miktarı ve operasyon süresi açısından istatistiksel açıdan fark yoktu. Ortalama kan kaybı finasterid alan grupta, kontrol grubuna göre istatistiksel açıdan anlamlı olarak düşüktü (p=0.017). Rezeke edilen gram prostat dokusu başına kan kaybı hesaplandığında, istatistiksel açıdan fark daha da anlamlı düşük olarak saptandı (p=0.005). Bu çalışma, preoperatif 2 hafta süreyle finasterid kullanımının TUR-P uygulanan hastalarda kanamayı azalttığını göstermiştir
71-74

REFERENCES

References: 

1. Span PN, Voller MC, Smals AG, et al: Selectivity of
finasteride as an in vivo inhibitor of 5 alpha-reductase
isozyme enzymatic activity in the human prostate. J Urol
1999; 161: 332-7.
2. Marshall S, Narayan P: Treatment of prostatic bleeding:
suppression of angiogenesis by androgen deprivation. J Urol
1993; 149:1553-54.
3. Lekas E, Bergh A, Damber JE et al: Effects of finasteride and
bicalutamide on prostatic blood flow in rats. BJU Int 2000; 85:
962-5.
4. Garraway WM, Russell EB, Lee RJ, et al: lmpact of
previously unrecognised benign prostatic hyperplasia on the
daily activities of middle aged and elderly men. BrJ Gen Pract
1993; 43: 318-21. M. Küçük, ark.
74
5. Girman CJ, Jacobsen SJ, Tsukamoto T, et al: Health related
quality of life associated with lower urinary tract symptoms in
four countries. Urology 1998; 51: 428-36.
6. Jacobsen SJ, Girman CJ, Guess HA, et al: New diagnostic and
treatment guidelines in benign prostatic hyperplasia. Arch
lntern Med 1995; 155: 477-81.
7. Berry SJ, Coffey DS, Walsh PC, et al: The development of
human benign prostatic hyperplasia with age. J Urol 1984;
132: 474-9.
8. Uygur MC, Arik Al, Altug U, et al: Effects of the 5 alphareductase inhibitor finasteride on serum levels of gonadal, adrenal, and hypophyseal hormones and its clinical significance:
a prospective clinical study. Steroids 1998;63: 208-13.
9. Mc Conneli JD, Bruskewitz R, Walsh P, et al: The effect of
finasteride on the risk of acute urinary retention and need for
surgical treatment among men with benign prostate
hyperplasia. Finasteride long term efticacy and safety study
group. N Engl J Med 1998; 338: 557-63.
10. Andersen JT, Nickel JC, Marshall VR, et al: Finasteride
significantly reduces acute urinary retention and need for
surgery in patient with symptomatic benign prostatic
hyperplasia. Urology 1997; 49: 839-45.
11. Mebust WK, holtgrewe HL, Cockett AT, et al: Transurethral
prostatectomy: immediate and postoperative compiications. A
cooperative study of 13 participating institutions evaluating
3885 patients. J Urol 1989; 141: 243-7.
12. Puchner PJ, Miller MI: The effect of finasteride on hematuria
associated with benign prostate hyperplasia: preliminary
report. J Urol 1995; 154: 1779-82.
13. Sieber PR, Rommel FM, Huffnagle HW, et al: The treatment
of gross hematuria secondary to prostatic bleeding with
finasteride. J Urol 1998; 1 59;1 232-33.
14. Pareek G, Shevchuk M, Armenakas NA, et al: The effect of
finasteride on the expression of vascular endothelial growth
factor and microvessel density. J Urol 2003; 169: 20-23.
15. Neal DE, Gangula R, Elfarr W, et al: Effect of androgen
ablation on angiogenesis in benign prostatic hyperplasia. J
Urol 1998; 159:102.
16. Gray N, Polakow ES: A study of premarine intravenous and
its influence on blood loss during transurethral prostatectomy.
J lntern Med Res 1979; 7: 96-99.
17. Luke M, Kvist E, Andersen F, et al: Reduction of post
operative bleeding after transurethral resection of the prostate
by local instillation of fibrin adhesive. BJU 1986;58: 672-5.
18. Szewczyk W: Blood Ioss during transurethral resection of the
prostate injected with phenol solution. Int Urol Nephrol. 1991;
23: 155-9.
19. Walker EM Bera S, Faiz M: Does catheter traction reduce post
transurethral resection of the prostate blood loss? BJU 1995;
75: 614-7.
20. Foley SJ, Soloman LZ, Wedderburn AW et al: A prospective
study of the natural history of hematuria associated with
benign prostatic hyperplasia and the effect of finasteride. J
Urol 2000; 163: 496.
21. Carlin Bl, Bodner DR, Spirnak JP et al: Role of finasteride in
the treatment of recurrent hematuria secondary to benign
prostatic hyperplasia. Prostate 1997; 31: 180.
22. Donohue JF, Sharma H, Abraham R, et al: Transurethral
prostate resection and bleeding: A randomized, placebo
controlled trial of the role of finasteride for decreasing
operative blood loss. J Urol 2002; 168: 2024-6.
23. Hagerty JA, Ginsberg PC, Harmon JD, et al: Pretreatment
with finasteride decreases perioperative bleeding associated
with transurethral prostate of the prostate. Urology 2000; 55:
684-9.
24. Sandfeldt L, Bailey DM, Hahn RG et al: Blood loss during
transurethral resection of the prostate after 3 months of
treatment with finasteride. Urology 2001;58: 972-6.
25. Lund 1, Ernst-Jensen KM, Torring N, et al: lmpact of
finasteride treatment on perioperative bleeding before
transurethral resection of the prostate: A prospective
randomized study. Scand J Urol Nephrol 2005;39: 160-2.

Thank you for copying data from http://www.arastirmax.com