The Effects of Finasteride on Hematuria Associated with Benign Prostatic Hyperplasia: A Preliminary Report

Puchner, Peter J.; Miller, Mark I.

doi:10.1016/s0022-5347(01)66782-x

Cited by 78 publications

(40 citation statements)

References 16 publications

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“…This may also lead to decreased angiogenesis and therefore, theoretically, decreased prostatic bleeding. Recently, ®nasteride has been suggested as an option in the treatment of this problem, with promising results [18,19]. The treatment of BPH with ®nasteride has been shown to produce marked changes in the levels of these growth factors, the postulated mechanism including down-regulation of both the growth factor receptors and the hormones themselves [13,14].…”

Section: Discussionmentioning

confidence: 99%

Microvessel density in prostatic hyperplasia

Foley

Bailey

2000

BJU International

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Objectives To examine the prostates from patients with haematuria associated with benign prostatic hyperplasia (BPH) to determine their microvascular anatomy and thus assess histopathological differences in patients with significant haematuria. Patients and methods Prospectively, 11 patients with BPH and haematuria (mean age 70 years) and 19 control patients with BPH alone (mean age 72 years) were identified. Neither group had received hormone manipulation or had been catheterized. The sub‐urothelial compartment of the prostatic urethra in subsequent specimens from transurethral resection was examined using factor VIII/CD‐34 immuno‐histochemistry. The microvessel density (MVD) was calculated by counting vascular cross‐sectional profiles within a 0.81‐mm2 grid. The pathologist studying the specimens was unaware of the patients’ symptoms. Results The median (range) MVD in the haematuria group was 64 (28–137) and in the controls was 27 (14–39) (P < 0.001). Conclusion The MVD was significantly greater in the patients with haematuria, suggesting that suburo‐thelial microvessel proliferation may play an important role in mediating haematuria associated with BPH. This is the first time that a difference has been shown at the cellular level in patients with haematuria and could form an important foundation for subsequent research.

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Section: Discussionmentioning

confidence: 99%

Microvessel density in prostatic hyperplasia

Foley

Bailey

2000

BJU International

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“…It also decreases the incidence of surgery and acute retention besides limiting hematuria in patients with BPH. [6][7][8] Animal and human studies with finasteride established a reduction in prostatic blood flow and vascular density, 9,10 which is probably related with the downregulation of vascular endothelial growth factors. Furthermore, patients with hematuria have elevated concentration of blood vessels in the suburethral tissue of the prostatic urethra, which presumably bleed after excursion.…”

Section: Introductionmentioning

confidence: 99%

Effect of short-term finasteride therapy on peroperative bleeding in patients who were candidates for transurethral resection of the prostate (TUR-P): a randomized controlled study

Ozdal

Özden

Benlı

et al. 2005

Prostate Cancer Prostatic Dis

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TurkeyIn the present study we aimed to demonstrate the efficacy of short-term pretreatment with finasteride in patients undergoing transurethral resection of the prostate (TUR-P). For this purpose 40 patients with BPH, who were candidates for TUR-P, were randomized into two groups. The first group (n ¼ 20) received 5 mg finasteride/day for 4 weeks prior to surgery and the second group (n ¼ 20) remained as the control. Patients who underwent prior prostate or urethral surgery and had a diagnosis of prostate cancer or chronic renal failure, patients who received finasteride, aspirin, coumadin or similar anticoagulant drugs prior to surgery and patients who had capsule perforations or open sinuses during the surgery were excluded from the study. All patients had a normal digital rectal examination and PSA values less than 4 ng/ml. As we look at the results there was no statistically significant difference between the finasteride group and control group regarding age, IPSS, PSA, prostate volumes, preoperative serum hemoglobin, hematocrit values and mean operating times and used irrigating fluids. The total amount of bleeding and bleeding per gram resected tissue were significantly lower in the finasteride group regardless of prostate volume. Furthermore the decrease in the hemoglobin and hematocrit values was higher in the control group. As a conclusion four weeks of finasteride pretreatment provided a significant decrease in peroperative bleeding regardless of prostate volume without any major side effects.

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“…BPH associated hematuria is probably related to the increased vascularity of the prostate [6,10]. It has been accepted that this angiogenesis can be suppressed by androgen deprivation, which was shown in the prostates of dogs who demonstrated a distinct reduction in prostatic blood flow after being treated with finasteride [11].…”

Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Prostat'ın transüretral rezeksiyonundan (TUR-P) önce uygulanan tek doz goserelin' in, benign prostat hiperplazisi (BPH) olan hastalarda kan kaybı ve prostat subüretral dokunun mikrovasküler dansitesi (MVD) üzerine olan etkilerinin belirlenmesi amaçlandı. Gereç ve Yöntem: TUR-P planlanan hastalar iki gruba randomize edilerek ayrıldı. Ameliyattan 1 ay önce 3,6 mg subkütan goserelin asetat uygulanan 18 hasta Grup 1'i oluşturdu. Grup 2 ise goserelin verilmeyen 21 hastadan oluşturuldu. İntraoperatif kanama miktarı ölçüldü.Her hasta için toplam kan kaybı, toplam kan kaybı/ ameliyat süresi, toplam kan kaybı/ rezeke edilen doku gramı hesaplandı. Prostat subüretral doku kesitleri mikrovasküler dansitesi açısından incelendi. Bulgular: Ameliyattan hemen sonra yapılan kontrolde; grup 1'deki hemoglobin (Hb) düşüşü grup 2'ye göre daha fazlaydı ve ortalama Hb seviyesi grup 1'de grup 2'ye kıyasla istatistiksel olarak anlamlı derecede düşük bulundu (p=0.028). İstatistiksel olarak anlamlı olmamasına rağmen irrigasyon sıvısında Hb konsantrasyonu ve ameliyat süresince kan kaybı grup 1'de grup 2'ye oranla daha yüksekti, buna karşılık TUR-P süresine göre ve rezeke edilen prostat doku ağırlığına göre kan kaybı ise grup 1'de grup 2'ye gore daha düşüktü. Mikrovasküler dansite grup 2'de belirgin olarak daha azdı. Tartışma: Bir aylık tek doz goserelin tedavisi, TUR-P boyunca olan kan kaybını azaltmada etkili değildir ve prostat dokusunda mikrovasküler dansitesi üzerinde süpresif etkisi yoktur. Anahtar KelimelerBenign Prostat Hiperplazisi; Goserelin; Mikrovasküler Dansite; Kan Kaybı; Prostatın Transüretral Rezeksiyonu Abstract Aim: To determine the effects of one dose goserelin before transurethral resection of the prostate (TUR-P) on blood loss and microvessel density (MVD) of prostatic suburethral tissues in the patients with benign prostatic hyperplasia (BPH). Material and Method: The patients who planned to have a TUR-P were randomly divided into two groups. Group-1 consisted of 18 patients who were pretreated with 3,6 mgr subcutaneous injection of goserelin acetate one month before the operation. Group-2 was constructed from 21 patients without goserelin acetate pretreatment. The amount of intraoperative haemorrhage was calculated. Total blood loss, total blood loss/duration of surgery and total blood loss/gram of resected tissue were calculated for each patient. Sections from the prostatic suburethral tissues were examined for microvessel density. Results: Quantitative decreases in Hb were greater in group 1 than in group 2, and mean Hb level was statistically significantly lower in group 1 than in group 2 at the control just after the operation (p=0.028). Although all the differences were statistically insignificant, Hb concentration in irrigation fluid and total blood loss during surgery were higher in the group 1 than in the group 2, contrarily, blood loss by duration of TURP and blood loss by weight of resected prostate tissue were less in the group 1 than in the group 2. The MVD was significantly lower in group 2 than ...

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The Effects of Finasteride on Hematuria Associated with Benign Prostatic Hyperplasia: A Preliminary Report

Abstract: Finasteride is effective in treating hematuria associated with BPH. This finding is especially relevant for patients with multiple medical problems and anesthetic risks.

Cited by 78 publications

References 16 publications

Microvessel density in prostatic hyperplasia

Microvessel density in prostatic hyperplasia

Effect of short-term finasteride therapy on peroperative bleeding in patients who were candidates for transurethral resection of the prostate (TUR-P): a randomized controlled study

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

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