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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

Impact of preoperative 5α-reductase inhibitors on perioperative blood loss in patients with benign prostatic hyperplasia: a meta-analysis of randomized controlled trials

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Yi-Ping Zhu, Bo Dai, Hai-Liang Zhang, Guo-hai Shi, Ding-Wei Ye
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

YPZ and DB performed the systematic review and meta-analysis. HLZ, GHS, and DWY identified the studies and participated in critical evaluation and discussion. All authors read and approved the final manuscript.

Abstract

Background

The ability of 5α-reductase inhibitors (5ARIs) to decrease blood loss during transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) remains controversial. We aimed to conduct a meta-analysis of all randomized controlled trials (RCTs) to establish the role of 5ARI use prior to TURP.

Methods

We searched studies from the electronic databases PubMed, Embase, Scopus, and Cochrane Library from inception to March 25, 2014. Meta-analysis was performed using the statistical software Review Manager version 5.1.

Results

Seventeen RCTs including 1489 patients were examined. We observed that preoperative treatment with finasteride can decrease total blood loss, blood loss per gram of resected prostate tissue, hemoglobin level alteration, microvessel density (MVD), and vascular endothelial growth factor level. Neither finasteride nor dutasteride reduced operative time, prostate volume, or the weight of gland resected. In contrast, pretreatment with dutasteride before TURP did not decrease the total blood loss or MVD.

Conclusions

Pretreatment with finasteride does seem to reduce perioperative blood loss related to TURP for BPH patients. However, the effect of preoperative dutasteride was inconclusive. Further studies are required to strengthen future recommendations regarding the use of 5ARI as a standard pre-TURP treatment and its optimal regimen.
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