Role of Dutasteride in Reducing the Complications of Transurethral Resection of Prostate

The development of prostate is dependent on the dihydrotestosterone. Testosterone conversion into dihydrotestosterone (DHT) is inhibited by the 5alpha reductase inhibitors like Finasteride and Dutasteride. Several studies showed that finasteride prevents recurrent gross hematuria in BPH (1) (2). Aim and Objective 1. To determine whether preoperative treatment with Dutasteride decreases surgical blood loss in patients who undergo transurethral resection of the prostate for benign prostatic hyperplasia with prostate greater than30cc volume with acute urinary retention.2. To assess the postoperative complication like clot retention, blood transfusion, failure to void after the catheter removal and the urinary tract infection in postoperative period Materials and methods The study was conducted between January 2016 and December 2016 in Chengalpattu medical college in the department of Urology. We studied 150 patients randomized into three groups of 50 each to undergo TURP. Group 1-receiving placebo for two weeks preoperatively and two weeks postoperatively. Group 2-receiving Tab. Dutasteride 0.5mg BD, for 2weeks preoperatively and two weeks postoperatively. Group 3-receiving Tab. Finasteride 5mg BD, two weeks preoperatively and 2weeks postoperatively. All clinical, blood, urine, imaging work up were done. The total blood loss during transurethral resection of prostate, incidence of clot retention, requirement of blood transfusion, failure to void after the cathter removal and the incidence of urinary tract infection were studied. Results Micro Vascular Density was significantly reduced in the suburethral prostatic epithelium by preoperative Dutasteride and Finasteride group when compared with the placebo group. Conclusion The present study shows two weeks preoperative Dutasteride 0.5 mg BD treatment in BPH will reduce the microvessel density in suburethral portion of prostatic urothelium. Dutasteride cause clot retention and blood transfusion in lesser number of post TURP patients. Preoperative Dutastride will reduce the TURP complication in BPH as Finasteride.