Benign prostatic hyperplasia (BPH) is an abnormal stromal and glandular proliferation of the prostate gland and is a common benign tumor found in men above 50 years of age. Most men who reach their average expectancy will experience this condition in their life time. The amount of intra-operative and postoperative bleeding depends on the gland size, surgeon’s expertise and duration of surgery. Intraoperative bleeding is usually controlled with electro-coagulation, but excessive intra and perioperative blood loss can cause hemodynamic instability, that may increase morbidity and mortality associated with the procedure. Proliferation of the prostatic glandular tissue depends on the androgen dihydro-testosterone, hence inhibition of 5α-reductase cause’s reduction of gland volume that will indirectly reduce the duration of surgery and decrease the blood loss.
Methods: The study was conducted in the Department of Urology, Katuri Medical College, Guntur, Andhra Pradesh. One hundred patients who underwent TURP for symptomatic BPH from September 2015 to December 2019 fulfilling the inclusion and exclusion criteria were included in the study.
Results: They were randomized in to group A (received 2 weeks of preoperative tab. Finasteride 5 mg OD) and group B (placebo group), with a total of fifty patients in each group. In 70% of the patients in this study group, the prostatic weight was between 40 to 60 grams. 10 out of 50 patients in group A and 9 out of 50 patients in group B had prostatic weight of more than 60 grams. There is significant haemoglobin drop difference between the groups. p=0.001.it’s statistically significant. Postoperative mean haemoglobin in group A & B were 10 grams and 9.4 grams/dl respectively. Postoperative mean PCV in both group A& B were 30 and 28%.
Conclusions: Pre-operative short course of finasteride therapy (Tab. finasteride 5 mg OD) definitely reduces the perioperative complications like intra and postoperative blood loss, persistent hematuria, need for blood transfusions, clot retention and postoperative voiding failure. It also decreases operative time, tissue microvessel density and post-operative UTI.