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[Effect of dutasteride on reduction of intraoperative bleeding related to transurethral resection of the prostate].

OBJECTIVE
The pharmacological action of 5-alpha-reductase inhibitors (5-ARI) would reduce angiogenesis associated with benign prostatic hyperplasia (BPH), thereby decreasing peroperative bleeding during transurethral resection of the prostate (TURP). Dutasteride, a double inhibitor of 5-alpha-reductase iso-enzymes types 1 and 2, was not been previously studied in the context of reduction of peroperative bleeding related to TURP.


MATERIAL AND METHODS
We conducted a multicentre, randomized, double-blind, placebo-controlled, parallel group study to evaluate the efficacy of dutasteride 0.5 mg per day, in peroperative bleeding related to TURP for BPH in patients over the age of 50 years with a prostatic volume greater than 30 cm3. Treatment was administered for 4 weeks before the operation. The primary endpoint was haemoglobin, expressed in grams, and expressed in relation to the weight of prostate resected, also expressed in grams.


RESULTS
59 patients were evaluated (32 treated with dutasteride and 27 treated with placebo). A significant difference in peroperative bleeding was observed between the dutasteride group (1.944 +/- 1.816 g of Hb/g of prostate resected) and the placebo group (1.401 +/- 1.021 g of Hb/g of prostate resected). Preoperative treatment was well tolerated.


CONCLUSION
The working hypothesis of the study was not confirmed due to the low bleeding rate in the placebo group and the results suggest that a longer duration of treatment with dutasteride would reduce intraoperative and postoperative bleeding in TURP.