Effects of Two Weeks Finasteride Therapy on Per-Operative Decrease in Haemoglobin Patients after Transuretheral Resection of Prostate (TURP)

Abstract

Objective: “To compare the per-operative mean decrease in hemoglobin level in patients undergoing transurethral resection of the prostate (TURP) taking Finasteride for two weeks before TURP versus without pre-treatment of Finasteride. Study Design: Quasi experimental study. Place and duration of study: Department of Urology, Combined Military Hospital, Multan from September 2023 to September 2024. Materials & Methods: This Quasi experimental study was conducted at Department of Urology, Combined Military Hospital Multan from September 2023 to September 2024 after taking permission from hospital ethical review board (IRB NO.82-2024). Informed consent was obtained from all patients before they are included in this study. Firstly, selected patients were explained with the theoretical benefits of Finasteride, its duration and the time he has to wait for surgery. If that patient agrees to Finasteride therapy, he was included in group A; if he does not agree, he was left for group B. Group A having 72 BPH patients was given Finasteride (5 mg/day) for two weeks before surgery. Group B was designated as control group also having 72 BPH patients and no drug was given before surgery. Data analysis was carried out using SPSS version 26. Mean and standard deviations was calculated for quantitative variables like age, duration of BPH disease, pre-op hemoglobin, post-op hemoglobin and decrease in Hemoglobin. Frequency and percentage was calculated for age groups, hypertension, and diabetic history. An independent sample t-test was applied to see significant differences in the per-operative decrease in hemoglobin in both groups.  Results: A total of 144 patients undergoing TURP due to BPH  having mean age 62.13 ± 8.37 years (range; 49 - 79 years) were included. Of these 144 study cases, 44.4 % (n = 64) belonged to age group of up to 60 years while 55.6 % (n = 80) were aged more than 60 years. Fifty three (36.8 %) belonged to rural localities and 63.2 % (n = 91) belonged to urban areas. Fifty (34.7%) had poor social background and 65.3 % (n = 94) were from middle income families. IPSS severity was mild in 9.0 % (n = 13), moderate in 45.1 % (n = 65) and severe in 45.8 % (n=66). Of these 144 study cases, 32.6 % (n = 47) were diabetic and 46.5 % (n = 67) were hypertensive. Thirty six (25.0% ) were obese with mean body mass index (BMI) was 25.71 ± 1.98 kg / m 2 . Mean pre-treatment Hb level was 12.68 ± 0.53 g/dl in group A versus 12.81 ± 0.52 g/dl in group B (P = 0.144) while mean post-treatment hemoglobin level was 12.60 ± 0.56 g/dl in group A versus 12.37 ± 0.60 g/dl in group B (P=0.020).  Conclusion: Our study support use of Finasteride in benign prostatic hyperplasia patients undergoing transurethral resection of the prostate (TURP) as per-operative mean hemoglobin level in patients undergoing transurethral resection of the prostate (TURP) taking Finasteride for two weeks before TURP was significantly higher as compared with control group. All urologists treating BPH patient with transurethral resection of the prostate can effectively employ Finasteride to achieve desired outcomes.