Comparison of Intraoperative Blood Loss in Patients With Benign Prostatic Hyperplasia Undergoing Bipolar...

Background Benign prostatic hyperplasia (BPH) is a common urological condition in aging males. Transurethral resection of the prostate (TURP) is a standard modality used for the surgical management of patients with BPH. Objectives The main objective of this study is to compare the blood loss among BPH patients undergoing bipolar TURP, with and without preoperative finasteride. Methodology A comparative observational study was conducted in the Department of Urology, Sir Ganga Ram Teaching Hospital, Lahore, Pakistan, from March 2023 to August 2023. A total of 60 BPH patients were distributed into two equally sized groups. The patients in Group A were given finasteride (5.0 mg once daily) for two weeks before undergoing bipolar TURP surgery, whereas the patients in Group B underwent bipolar TURP surgery without finasteride. Intraoperative blood loss was calculated in terms of a decrease in hemoglobin (Hb) level, defined as the difference between preoperative Hb and postoperative Hb, measured 24 hours after TURP. Results Baseline variables, including mean age (64.4 ± 4.2 vs. 62.9 ± 5.2 years; p-value = 0.528), mean prostate volume (75.64 ± 12.05 vs. 69.75 ± 12.91 grams; p-value = 0.054), median BMI 23.0 (22.0-24.0) vs. 23.0 (21.0-24.0) kg/m²; p-value = 0.341, and median preoperative Hb level 14.0 (14.0-16.0) vs. 14.0 (13.0-15.0) g/dL; p-value = 0.132, were similar between the two groups. Median postoperative Hb level 14.0 (13.0-15.0) vs. 13.0 (11.0-14.0) g/dL; p-value = 0.005 was significantly different between groups. Median blood loss 0.4 (0.3-0.7) g/dL in the finasteride group was markedly lower than 1.3 (0.9-1.8) g/dL in the control group (p-value < 0.001). The need for blood transfusion, 3.6% in the finasteride group and 13.3% in the control group, was not significantly different (p-value = 0.611). Median hospital stay, 26.0 (24.0-28.0) hours in the finasteride group, was markedly shorter than 28.0 (26.0-30.0) hours in the control group (p-value = 0.011). Conclusion The study concluded that preoperative treatment with finasteride for 14 days effectively decreased intraoperative blood loss in patients with BPH who underwent bipolar TURP in our hospital. Therefore, preoperative finasteride can be used to reduce blood loss and associated complications in BPH cases scheduled for bipolar TURP.