Abstract

Objective: Open prostatectomy (OP) is a valid option for the surgical treatment of large prostates in the absence of holmium laser enucleation. The most frequent complication of OP is intra- and perioperative bleeding. Preoperative use of dutasteride has been shown to reduce vascularity and perioperative bleeding in transurethral resection of the prostate (TUR-P). However, there has been no study addresing this effect in OP. The aim of this study was to evaluate whether pretreatment with dutasteride for 6 weeks before OP can reduce surgical blood loss.

Material and methods: Data of 218 patients with benign prostatic hyperplasia (BPH) who underwent OP was investigated retrospectively. Of the 218 patients, 46 were treated with dutasteride for at least 6 weeks and the rest were dutasteride naive. Age, prostate volume, prostate-specific antigen (PSA) levels, coagulation tests, platelet counts, pre- and postoperative hemoglobin (Hb) levels, and transfusion history were recorded. Blood loss was estimated as follows: preoperative Hb (-) postoperative Hb (+) amount of transfusion. The 2 groups were compared by independent samples t-test and a p value of 0.05 was considered significant.

Results: The groups were similar in terms of age, prostate volume, platelet counts, coagulation tests, and postoperative Hb levels. Preoperative Hb levels were lower in the dutasteride group (13.4 vs. 14.3, p=0.002) and amount of bleeding (-2.72 g/dL vs. -1.93 g/dL, p=0.01) was shown to be significantly lower in dutasteride group. 

Conclusion: Our results showed that pretreatment with dutasteride for 6 weeks before OP considerably reduces perioperative surgical bleeding. Further prospective randomized trials should be conducted to confirm the effectiveness of such treatment.