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

5α-reductase inhibitors （5α-RIs）, including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia （BPH）. Many studies reported that preoperative 5α-RI had impact on intraoperative haemorrhage during surgery for BPH, but it was still in controversial. So, w...

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Bibliographic Details
Published in:Asian journal of andrology 2011-11, Vol.13 (6), p.812-818
Main Authors: Zong, Huan-Tao, Peng, Xiao-Xia, Yang, Chen-Chen, Zhang, Yong
Format: Article
Language:English
Subjects:
5-alpha Reductase Inhibitors - pharmacology
5-alpha Reductase Inhibitors - therapeutic use
Azasteroids - pharmacology
Azasteroids - therapeutic use
Blood Loss, Surgical - prevention & control
Dutasteride
Finasteride - pharmacology
Finasteride - therapeutic use
Humans
Male
Original
Prostatic Hyperplasia - surgery
Randomized Controlled Trials as Topic
Treatment Outcome
大出血
审查
手术治疗
机制
系统
良性前列腺增生
还原酶抑制剂
随机对照试验
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Summary:5α-reductase inhibitors （5α-RIs）, including finasteride and dutasteride, are commonly used medical therapies for benign prostatic hyperplasia （BPH）. Many studies reported that preoperative 5α-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 5α-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-qualitv prospective studies are still needed to confirm this observation.
ISSN:1008-682X
1745-7262
DOI:10.1038/aja.2011.86