Perioperative bleeding is the most common complication related to transurethral resection of prostate;
the aim of the study was to compare the effect of pre-operative use of finasteride versus cyproterone acetate (CPA)
on blood loss with monopolar TURP.
Methods: This prospective randomized controlled study was conducted on (60) patients with BPH underwent
monopolar TURP between July 2019 and July 2020. Patients were distributed into three equal groups; CPA group:
20 patients received cyproterone acetate 50 mg tab BID for two weeks before TURP, finasteride group: 20 patients
received single daily dose of finasteride 5 mg for two weeks before TURP, control group: 20 patients received no treatment
before TURP, all patients underwent monopolar TURP, and then histopathological examination of the resected
tissues was done with assessment of the microvascular density of the prostate.
Results: Our study showed that there was significant decrease in intraoperative blood loss and operative time in CPA
and finasteride groups in comparison with control group (p = 0.0012) (p < 0.0001), respectively, significant decrease in
post-operative Hb and HCT value in finasteride and control groups in comparison with CPA group (p < 0.01), significant
increase in specimen weight in CPA group compared to other groups (p < 0.01), and there was also significant
decrease in microvascular density in CPA group in comparison with other groups (p < 0.01).
Conclusion: Cyproterone acetate is more effective than finasteride in decreasing perioperative bleeding with TURP
by decreasing microvascular density of the prostate.