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Surgical blood loss during holmium laser enucleation of the prostate (HoLEP) is not affected by short-term pretreatment with dutasteride: a double-blind placebo-controlled trial on prostate vascularity.
- Source :
-
Aging [Aging (Albany NY)] 2020 Mar 11; Vol. 12 (5), pp. 4337-4347. Date of Electronic Publication: 2020 Mar 11. - Publication Year :
- 2020
-
Abstract
- Five α-reductase inhibitors (5ARIs) are able to reduce prostate volume and are a useful treatment for reducing perioperative bleeding during prostate surgery. Holmium laser enucleation of the prostate (HoLEP) is an effective surgical technique for the definitive cure of benign prostate enlargement.We investigated whether pretreatment with dutasteride before HoLEP could reduce intraoperative bleeding. A total of 402 patients were included in this double-blind placebo-controlled trial to receive daily 0.5 mg of dutasteride or placebo over 8 weeks before HoLEP. Vascular endothelial growth factor (VEGF) and microvascular density (MVD) were evaluated. Analysis was also stratified according to prostate volume (<70 mL vs ≥70 mL).Hemoglobin and hematocrit values before and after surgery were not statistically different between the two groups. MVD and VEGF index in smaller prostates were 23.35±1.96 and 4.06±0.76 in the treatment group and 19.04±0.96 and 2.55±0.55 in placebo (p<0.05); in patients with larger prostates MVD and VEGF were 26.83±2.812 and 8.54±1.18 in the treatment group and 20.76±0.79 and 3.21±0.54 in placebo (p<0.05).Vascularization of the prostate was affected by 5ARIs therapy. HoLEP is less burdened in perioperative bleeding and for this reason we did not find any difference in hemoglobin/hematocrit values pre- and post- surgery.
- Subjects :
- Aged
Aged, 80 and over
Double-Blind Method
Holmium
Humans
Male
Middle Aged
Prostate metabolism
Prostatic Hyperplasia drug therapy
Prostatic Hyperplasia metabolism
Treatment Outcome
Vascular Endothelial Growth Factor A metabolism
5-alpha Reductase Inhibitors therapeutic use
Blood Loss, Surgical
Dutasteride therapeutic use
Lasers, Solid-State therapeutic use
Prostate surgery
Prostatic Hyperplasia surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1945-4589
- Volume :
- 12
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Aging
- Publication Type :
- Academic Journal
- Accession number :
- 32167484
- Full Text :
- https://doi.org/10.18632/aging.102883