Randomized, placebo‐controlled trial showing that finasteride reduces prostatic vascularity rapidly within 2 weeks

Abstract

assess MVD. Ten consecutive, nonoverlapping high-power fields were analysed in a blinded fashion. RESULTSIn all, 31 men received finasteride and 33 placebo; the groups were similar in patient age, resected prostate weight, preoperative catheterization, prostate-specific antigen level, aspirin use, spinal anaesthesia and postoperative diagnosis of prostate cancer. The mean (95% confidence interval) MVD was significantly lower in the finasteride group (60, 55-65) than in the placebo group (71, 64-78; P < 0.01). Similarly, the mean expression of VEGF was significantly lower in the finasteride group (47, 43-52 vs 61, 54-67; P < 0.001) CONCLUSIONFinasteride inhibits angiogenic growth factors leading to reduced vascularity, and this is the basis of its action in reducing haematuria of prostatic origin. The present study shows that finasteride influences the prostatic microvasculature after only 2 weeks exposure.

Clinical Studies on Postcoital Hematuria

“…[15][16][17][18][19] Therefore, 5α-reductase inhibitors might be helpful in controlling postcoital hematuria in cases with benign prostatic hyperplasia, which was shown in our cases and the case reported by Chen et al 15 In 3 patients with seminal vesicle dilatation diagnosed by transrectal ultrasonography, antibiotic administration or simple observation was done. Expressed prostatic secretion was normal in these patients.…”

Eficacia de la fotovaporización prostática con láser verde en el tratamiento de la hiperplasia prostática en pacientes en tratamiento con inhibidores de la 5-alfa-reductasa

“…El efecto de los 5ARI en el tejido prostático está ampliamente demostrado, constatándose una involución y fibrosis en el tejido prostático y una disminución de la microvascularización por inhibición de la angiogénesis, además de producir un descenso en la expresión de factor de crecimiento endotelial vascular 14 . De esta forma, diferentes estudios han demostrado una reducción en la microvascularización suburetral [15][16][17] . Estas características los convierten en unos fármacos eficaces para el tratamiento de la HBP, bien solos o en asociación con bloqueadores alfa, ya que disminuyen el tamaño prostático, la necesidad de cirugía y la probabilidad de sangrado en pacientes que padecen HBP 18 .…”

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

“…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.…”