Comparison of Intraoperative Blood Loss in Monopolar Transurethral Resection of the Prostate With and Without Two Weeks of Preoperative Dutasteride

TL;DR

Giving dutasteride before prostate surgery reduces blood loss during the procedure, according to a study comparing patients who took the drug versus those who did not.

Contribution

Demonstrates that preoperative dutasteride reduces intraoperative blood loss in monopolar TURP procedures.

Findings

Patients receiving dutasteride had 296ml average blood loss versus 370ml in the control group.

Blood loss per gram was 11.7ml/g in the dutasteride group versus 14.7ml/g in the control group.

Operative time was shorter (42 minutes) in the dutasteride group compared to 49 minutes in the control group.

Abstract

Introduction: Monopolar transurethral resection of the prostate (TURP) is a common surgical procedure for benign prostatic hyperplasia, often associated with significant intraoperative blood loss. Dutasteride, a 5-alpha reductase inhibitor, has been recommended to reduce perioperative bleeding by decreasing vascularity within the prostate.

Objective: The purpose of this study was to investigate the impact of pre-operative administration of dutasteride for a duration of two weeks on the reduction of intra-operative blood loss in patients undergoing monopolar TURP.

Method: This prospective, two-armed, quasi-experimental study enrolled 132 patients based on the specified inclusion criteria. Patients who fulfilled the criteria for monopolar TURP were administered 0.5mg dutasteride for two weeks prior to their TURP procedure. Afterward, these patients were admitted to the hospital ward and underwent the necessary preparations for the surgery. During the surgical procedure, the intra-operative irrigation fluid was quantified and collected and the hemoglobin (Hb) was tested. The amount of blood loss was then determined using an appropriate equation. The assessment of blood loss was conducted using several indicators, including the analysis of irrigation fluid, the measurement of Hb levels in the irrigation fluid, the preoperative Hb levels, and the weight of the resected tissue.

Result: A significant decline in blood loss was observed in the interventional group in comparison to the control group. The average blood loss observed in Group A was 296ml, whereas in Group B it was 370ml. Furthermore, the blood loss per gram was found to be 11.7ml/g in Group A and 14.7ml/g in Group B. The mean operative time for Group A was recorded as 42 minutes, while Group B had a mean operative time of 49 minutes.

Conclusion: The study's findings indicate a significant superiority of administering dutasteride before surgery for a duration of two weeks. A substantial reduction in both intraoperative blood loss and blood loss per gram is seen in patients who underwent monopolar TURP with dutasteride.