Finasteride effects on hypoxia and angiogenetic markers in benign prostatic hyperplasia

Lekas, A.; Lazaris, Andreas C.; Chrisofos, Michael; Papatsoris, Athanasios; Lappas, Dimitrios; Patsouris, Efstratios; Deliveliotis, Ch.

doi:10.1016/j.urology.2006.03.038

Cited by 31 publications

(23 citation statements)

References 28 publications

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“…This corresponds to 4 days for those treated with dutasteride and 6 days for those who had irrigation only. The fact that haematuria resolved in less than 5 days when dutasteride was used does not agree with the mechanisms of apoptosis and prostate shrinkage which were earlier considered as the main mechanisms of action of 5-α reductase inhibitors (5ARIs) [15]. Prostate shrinkage occurs only after about 6 months of treatment with 5ARIs [5] [16].…”

Section: Discussionmentioning

confidence: 93%

The Role of Dutasteride in Acute Prostatic Haematuria

Ofuru¹,

Obiorah²

2017

IJCM

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Background: Dutasteride has been found to reduce chronic prostatic bleeding and when taken 2 -6 weeks preoperatively reduces bleeding during transurethral prostate resection. The aim of this study is to determine if the drug will be effective in the control of acute gross prostatic haematuria. Patients and Method: 87 Consecutive patients with gross haematuria were enrolled. Clotting Profile, Cystoscopy and Intravenous Urography were done to exclude haematuria from medical, renal and bladder causes. Patients suspected to have prostatic haematuria were further evaluated using serum Prostate specific antigen (PSA) and Prostate scan. Those with elevated PSA ≥ 10 ng/ml and abnormal digital rectal examination (DRE) finding had prostate biopsy. The patients were randomly divided into 2 treatment groups. The control group had Normal saline irrigation and broad spectrum antibiotics while the second group received 0.5 mg oral dutasteride in addition. The time taken and volume of irrigation fluid used before haematuria stopped were noted. Statistical analysis was done using SPSS version 20.0. Result: 75 patients had haematuria of prostatic origin. 49 (65.3%) of these had benign prostatic hyperplasia (BPH) and 26 (34.7%) had cancer of prostate. 25(51%) of the 49 patients with BPH had Normal saline irrigation and antibiotics while 24 (49%) had oral dutasteride in addition. 14 (53.8%) of the prostate cancer patients had Normal saline irrigation and antibiotics while 12 (46.2%) had dutasteride in addition. Haematuria resolved in significantly shorter length of time using lesser volume of irrigation fluid in those treated with dutasteride than in those on control arm. Conclusion: Addition of 0.5 mg oral dutasteride daily leads to early resolution of acute prostatic haematuria.

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Section: Discussionmentioning

confidence: 93%

The Role of Dutasteride in Acute Prostatic Haematuria

Ofuru¹,

Obiorah²

2017

IJCM

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“…8,11,15 Seven out of 15 studies used blinding methods, 5,9,10,14,18,19,21 including four doubleblinded RCTs. 10,12,18,19 One of these 15 studies performed a power calculation to assess the optimal sample size, 11 and one used an intention-to-treat analysis.…”

Section: Quality Of Individual Studiesmentioning

confidence: 99%

“…Six studies of the effects of preoperative finasteride on total blood loss during surgery for BPH were identified, which involved 486 participants (240 in the treatment group and 246 in the control group); conclusions differed across studies. [5][6][7][8]11,12 No significant differences were found with respect to the resection weights of the samples. Two of the six articles were not included in the meta-analysis because they failed to report SD.…”

Section: Clinical Outcome After Preoperative Finasteride Treatmentmentioning

confidence: 99%

“…Two of the six articles were not included in the meta-analysis because they failed to report SD. 8,11 In total, only four trials were included in the meta-analysis, representing Figure 2 Effects of preoperative finasteride treatment on bleeding during TURP and its mechanisms. The volume of prevented blood loss ranged from 47.85 to 109.34 ml (P,0.00001), the volume of blood loss prevented per gram of resected prostate tissue ranged from 1.1 to 6.39 ml g 21 (P50.01) (the range of prevented blood loss volume and blood loss volume per gram of resected prostate tissue were calculated on the reciprocal mean of different trials).…”

Section: Clinical Outcome After Preoperative Finasteride Treatmentmentioning

confidence: 99%

“…3,4 However, the ability of finasteride to decrease blood loss during surgical interventions for BPH and its mechanisms of action remain controversial. [5][6][7][8][9][10][11][12][13][14][15] Although one meta-analysis focused on the effects of preoperative finasteride on reducing bleeding during transurethral resection of prostate (TURP), 16 the number of experiments included was insufficient and the underlying mechanisms for these treatment effects were not considered.…”

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confidence: 99%

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A systematic review of the effects and mechanisms of preoperative 5α-reductase inhibitors on intraoperative haemorrhage during surgery for benign prostatic hyperplasia

Zong

Peng²,

Yang³

et al. 2011

Asian J Androl

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1 5a-reductase inhibitors (5a-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Many studies reported that preoperative 5a-RI had impact on intraoperative haemorrhage during surgery for BPH, but it was still in controversial. So, we conducted a systematic review of the effects and mechanisms of 5a-RIs on intraoperative bleeding for BPH. MEDLINE, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials and the reference lists of retrieved studies were searched in the analysis. Sixteen publications involving 15 different randomized controlled trials (RCTs) and a total of 1156 patients were used in the analysis, including 10 RCTs for finasteride and five RCTs for dutasteride. We found that preoperative finasteride treatment decreases microvessel density (MVD) in resected prostate specimens. Total blood loss, blood loss per gram of resected prostate tissue and decreases in haemoglobin were all greatly reduced in the finasteride group as compared to controls. Dutasteride appeared to have no effect on bleeding. This meta-analysis shows that preoperative finasteride treatment could decrease intraoperative haemorrhage during surgery for BPH. Preoperative dutasteride had no effect on intraoperative haemorrhage, but further high-quality prospective studies are still needed to confirm this observation. Asian Journal of Andrology (2011) 13, 812-818; doi:10.1038/aja.2011.86; published online 5 September 2011Keywords: 5a-reductase inhibitor; benign prostate hyperplasia; haemorrhage; meta-analysis; microvessel density INTRODUCTION 5a-reductase inhibitors (5a-RIs), including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia (BPH). Finasteride, a type II 5a-RI, blocks the conversion of testosterone to dihydrotestosterone. Inhibition of 5a-reductase reduces the concentration of dihydrotestosterone in the prostate, which results in a decreased volume of the prostate, improved urinary flow and a decline in the incidence of acute urinary retention and the need for surgery.

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