Blood loss during transurethral resection of the prostate after 3 months of treatment with finasteride

Objectives. To study whether pretreatment with finasteride, compared with placebo, reduces the blood loss, operating time, amount of irrigating fluid absorbed, resources used, and other exploratory indexes of extensive surgery during transurethral resection of the prostate (TURP). Methods. This double-blind, randomized, placebo-controlled, single-center, 6-month pilot study was designed to study the effects of 3 months of finasteride (5 mg daily) on blood loss during surgery in 60 men who required TURP. The prostate size was measured by transrectal ultrasonography, the surgical blood loss was measured by a HemoCue photometer, and fluid absorption was determined by the ethanol method. The microvessel density was counted using microscopic staining and immunoperoxidase techniques. Results. Finasteride significantly reduced the prostate size before TURP (P<0.001 versus placebo). No significant between-group differences were found in blood loss (geometric mean 257 and 268 mL for finasteride versus placebo), fluid absorption, operating time, resection weight, or microvessel density. A positive correlation was found between the blood loss and the resection weight. Exploratory analyses indicated that finasteride might reduce the proportion of patients with high blood loss volumes. For prostates with resection weights greater than or equal to the median (18.6 g), finasteride was associated with less blood loss (median 324 mL, n=14) than in the controls (median 547 mL, n=14, P<0.01). Conclusions. Pretreatment with finasteride may help reduce the blood loss in TURP, except in the smallest resections. UROLOGY 58: 972-976, 2001. (C) 2001, Elsevier Science Inc.