TURP remains a gold standard procedure for BPH in most centers. Preoperative short term Finasteride helps reducing intraoperative bleeding regardless of prostate volume in TURP.
Basically, we suggest patients to take Finasteride 3 months before TURP, which can significantly reduce bleeding during surgery. We also found that one month Finasteride therapy prior to TURP seems to be able to reduce bleeding compared to controls matched age and prostate volume.
Recent meta-analyses showed that pretreatment with finasteride does seem to reduce perioperative blood loss related to TURP for BPH patients. However, the effect of preoperative dutasteride was inconclusive. We should not always follow old ideas without being supported by level-1 evidence
One month therapy reduces the risk of intraoperative bleeding but i don't think that the outcome is clinically relevant
Many publications confirm the significant effect of 3 months pre TURP with either Finasteride or Dutasteride. Actually i never did that intentionally to patients prior to TURP unless they were already using these drugs for possible medical control of their enlarged prostate. But; i have high experience in the significant effect of Finasteride treatment given post TURP for selected cases with large prostate, that develop intermittent attacks of hematuria. I give Finasteride for 1 month post TURP and that usually allows a smooth postoperative course.
currently with experience in laser surgery, I think it's irrelevant the use of these drugs , there is no randomized trial currently showing a lower rate of bleeding.
if the patient had retension of urine this means that he should be kept on catheter for at least one month to get a doubtful results.
I use it for large prostate 10mg aday for 10 days. and we can ask the anesthetest to did a hypotensive procedure.
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