Pretreatment with finasteride decreases perioperative bleeding associated with transurethral resection of the prostate

Objectives. The efficacy of finasteride in the treatment of gross hematuria associated with benign prostatic hyperplasia is well established. We evalu ated a regimen of pretreatment with finasteride in decreasing perioperative bleeding associated with transurethral resection of the prostate (TURP). Methods. A prospective analysis compared 25 patients pretreated with finast eride for 2 to 4 months before TURF with 50 patients without pretreatment. Patients in each group were further separated by the amount of prostate tis sue resected. Patients were then followed up for perioperative bleeding, de fined as a perioperative blood transfusion requirement or a return visit to the emergency room with gross hematuria or clot retention. Results. None of the patients with less than 30 g of prostate tissue resect ed experienced perioperative bleeding. In patients with 30 g or more resect ed, several episodes of bleeding occurred. In the patients pretreated with finasteride, 1 (8.3%) of 12 experienced perioperative bleeding; in the cont rol group, 7 (36.8%) of 19 had an episode of bleeding. Conclusions. In patients with large prostate glands undergoing TURP, pretre atment with finasteride appears useful in reducing perioperative bleeding. UROLOGY 55: 684-689, 2000. (C) 2000, Elsevier Science Inc.