Objective To evaluate the effect of epristeride on gross hematuria secondary to transurethral resection of prostate (TURP). Methods A total of 50 patients with gross hematuria secondary to TURP were divided into two groups: 25 patients were treated with routine treatment plus 5 mg epristeride, twice a day for 3 months, while the other 25 only received routine treatment. Results At the 6-month follow-up visit, gross hematuria recurred in 63% of patients in the control group, but in only 30% of patients in the epristeride group. The difference was statistically significant (Plt;0.05). Moreover, the grade of gross hematuria was significantly lower in the epristeride group (Plt;0.05). Conclusion Epristeride appears to be effective in treating gross hematuria secondary to TURP.
Objective To assess the efficacy of finasteride in treating perioperative bleeding in patients undergoing transurethral resection of the prostate (TURP). Methods We searched MEDLINE (1966 to 2005), EMBase (1984 to 2004), CBM (1980 to 2005), The Cochrane Library (Issue 4, 2005) and relevant journals to identify cl inical trials involving finasteride in patients undergoing TURP. We also checked the references in the reports of each included trial. The qual ity of randomized controlled trials (RCTs) was assessed according to the methods recommended by The Cochrane Collaboration, and the qual ity of non-RCTs was assessed based on the methods recommended by Jiang-ping Liu, Stroup and Hailey. Two reviewers extracted data independently and data analyses were conducted with The Cochrane Collaboration’ s RevMan 4.2. Result We included 4 RCTs and 1 non-RCT. The qual ity of 3 RCTs was graded C and the other one was graded B. The quality of the non-RCT was relatively high. Meta-analyses showed that with comparable age, international prostate symptom score, prostate specific antigen, preoperative volume of prostate and excision volume between the two groups (Pgt;0.05), the perioperative bleeding volume (WMD –85.44, 95%CI –117.31 to –53.58), the bleeding volume per gram of resected prostate tissue (WMD –3.5, 95%CI –6.34 to –0.58) and hemoglobin reduction (WMD –1.61, 95%CI –1.96 to –1.26) of the finasteride group were significantly smaller than those of the control group. Conclusion The evidence currently available indicates that preoperative use of finasteride may reduce bleeding in patients undergoing TURP.
Objective To evaluate the effect of pretreatment with epristeride on decreasing intraoperative bleeding during transurethral resection of prostate (TURP) and to study its mechanism. Methods A total of 60 patients with benign prostatic hyperplasia undergoing TURP were divided into two groups: 30 patients were pretreated with epristeride 5 mg×2 daily for 7 to 11 days before TURP, and 30 patients did not receive any pretreatment. The operations for the two groups of patients were conducted by the same doctors. The operation time, the weight of resected prostatic tissue, and the volume of irrigating fluid were recorded. Blood loss, bleeding index, and bleeding intensity were calculated. Microvessel density (MVD), vascular endothelial growth factors (VEGF), and nitric oxide synthase type III (eNOS) expression were measured by the immunohistochemistry SPmethod in prostatic tissue. Results In the epristeride and control groups, the mean blood loss was 179.51±78.29 ml and 237.95±124.38 ml (Plt;0.05); the mean bleeding index was 7.68±3.94 ml/g and 9.73±3.42 ml/g (Plt;0.05); the mean bleeding intensity was 2.43±1.03 ml/min and 3.30±1.50 ml/min (Plt;0.05); the mean value of MVD was 18.80±5.68 and 23.70±4.91 (Plt;0.05); the mean rank of VEGF was 23.48 and 31.77 (Plt;0.05); and the mean rank of eNOS was 22.36 and 31.14 (Plt;0.05), respectively. Conclusion Pretreatment with epristeride decreases intraoperative bleeding during TURP. The preliminary results suggest that angiogenesis in the prostatic tissue is suppressed.
Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in men undergoing transurethral resection of prostate (TURP) who have sterile preoperative urine. Method MEDLINE, EMBASE and Cochrane Library were searched for RCTs comparing antibiotic prophylaxis and placebo/blank controls for men undergoing TURP with preoperative sterile urine. The search strategy was established according to the Cochrane Prostatic Diseases and Urologic Cancers Group search strategy. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results Fifty three relevant trials were searched, of which 27 trials were included and 26 were excluded. Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria.The pooled relative risk (RR) and 95% confidence interval were 0.36 (0.28, 0.46). Conclusions Prophylactic antibiotics could significantly decrease the incidence of post-TURP bacteriuria. Further comparative RCTs and cost-effective should be performed analysis to establish the optimal antibiotic regimes for the benefit of patients undergoing TURP.
【摘要】 目的 探讨采用不同方法经尿道前列腺等离子双极电切术（plasmakinetic resection of prostate，PKRP）的方法及疗效。 方法 2008年7月-2009年12月，应用不同方法行PKRP治疗156例前列腺增生。患者年龄59~87岁，平均74岁。病程20 d~18年。前列腺重量22~100 g，平均38 g。采用单纯顺行电切法治疗38例，部分剜除分割切除法治疗76例，完全剜除法治疗42例。 结果 156例手术均获成功，手术时间平均90 min。获得前列腺组织12~87 g，平均35 g。术后留置导尿管平均5.5 d，住院时间平均6.5 d。术后组织病理学诊断为良性前列腺增生152例，前列腺癌4例。拔除尿管后均能自主排尿，部分患者术后有尿道刺激症状；术后1个月内出现尿道外口狭窄3例，经尿道扩张治愈。随访时间1~12个月，平均6个月。短期尿失禁3例，时间分别为1周、1个月及3个月；无长期尿失禁。术后3个月国际前列腺症状评分（IPSS）症状评分平均减少24分，生活质量评分平均减少3分。 结论 PKRP安全、有效、并发症少，可针对患者情况采用不同切割方法，效果更佳。【Abstract】 Objective To explore the effects and methods of transurethral plasmakinetic resection of prostate(PKRP). Methods A total of 156 patients with prostatic hyperplasia were treated with various methods of transurethral PKRP from July 2008 to December 2009. Patient’s age ranged from 59 to 87 years,74 years on average. The disease duration was 20 days to 18 years.Method one:anterograde resection in 38 patients; method two:partition retrograde enucleation in 76 patients; method three:completely retrograde enucleation in 42 patients. Results All of the swgeries were successful. The mean duration of the operation was 90 minutes.The collected prostatic specimens were 12-87 g,35 g on average. The mean catheter remaining dwation was 5.5 days.The mean postoperative hospital stay was 6.5 days. Conclusions PKRP is safe and effective. It is effective with various methods of transurethral plasmakinetic resection of prostate.