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Is There a Role for Preoperative 5 Alpha Reductase Inhibitors in Reducing Prostate Vascularity and Blood Loss?

  • Benign Prostatic Hyperplasia (K McVary, Section Editor)
  • Published:
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Abstract

Benign prostatic hyperplasia (BPH) and the related medical problems are a major burden as health care costs and as a cause of patient morbidity. The introduction of medical therapy largely offered an alternative to surgical therapy, and these medications have been linked with multiple positive BPH-related outcomes. With ubiquitous use, however, a variety of adverse side effects and unsupported claims to these medications have been reported both in scientific literature and popular press. The use of 5 alpha reductase inhibitors (5ARIs) to reduce recurrent bleeding due to BPH is a reasonable option for men with recurrent trips to the physician or hospital. After a largely anecdotal report of their use in the preoperative period to reduce bleeding during BPH surgery, there was interest in the use of 5ARIs for this indication considering the effusive bleeding that can occur during BPH-related surgery, a dreaded and not uncommon complication. While the pathophysiology for the use of 5ARI to reduce BPH-related bleeding is sound, the actual clinical outcomes still require scrutiny to determine if the efficacy is both scientifically valid and clinically significant. This report will review the current literature on this topic and make attempts to determine if the use of a 5ARI before BPH-related surgery should be encouraged.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Albany Medical College, 23 Hackett Blvd, Albany, NY, 12208, USA

    Matthew Bruha & Charles Welliver

  2. Albany Stratton Veterans Affairs Medical Center, Albany, NY, USA

    Charles Welliver

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  1. Matthew Bruha
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  2. Charles Welliver
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Correspondence to Charles Welliver.

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Matthew Bruha declares no potential conflicts of interest.

Charles Welliver reports honorarium from the American Society of Andrology, a paid reviewer for BMJ and Oakstone Publishing, and a consultant for Coloplast.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Benign Prostatic Hyperplasia

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Bruha, M., Welliver, C. Is There a Role for Preoperative 5 Alpha Reductase Inhibitors in Reducing Prostate Vascularity and Blood Loss?. Curr Urol Rep 18, 75 (2017). https://doi.org/10.1007/s11934-017-0730-7

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  • DOI: https://doi.org/10.1007/s11934-017-0730-7

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