Effect of Epristeride on Decreasing Intraoperative Bleeding During Transurethral Resection of Prostate_Chinese Journal of Evidence-Based Medicine

Authors：

DENG Hua ¹ ,  WEI Qiang ¹ , LI Tao ² , YUAN Renbin ³ , LI Qijun ¹

1. Department of Urology, West China Hospital of Sichuan University, Chengdu 610041, China2. Department of Obstetrics, West China Second Hospital of Sichuan University, Chengdu 610041, China3. Department of Urology, The No.3 People’s Hospital of Chengdu, Chengdu 610031, China;

Corresponding author：

WEI Qiang, Email: wq933@hotmail.com

Keywords：

Benign prostati c hyperplasia; Epristeride; Hemorrhage; Transurethral resection of prostate

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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 (P lt;0.05); the mean bleeding index was 7.68±3.94 ml/g and 9.73±3.42 ml/g (P lt;0.05); the mean bleeding intensity was 2.43±1.03 ml/min and 3.30±1.50 ml/min (P lt;0.05); the mean value of MVD was 18.80±5.68 and 23.70±4.91 (P lt;0.05); the mean rank of VEGF was 23.48 and 31.77 (P lt;0.05); and the mean rank of eNOS was 22.36 and 31.14 (P lt;0.05), respectively.
Conclusion 　Pretreatment with epristeride decreases intraoperative bleeding during TURP. The preliminary results suggest that angiogenesis in the prostatic tissue is suppressed.

Citation： DENG Hua,WEI Qiang,LI Tao,YUAN Renbin,LI Qijun. Effect of Epristeride on Decreasing Intraoperative Bleeding During Transurethral Resection of Prostate. Chinese Journal of Evidence-Based Medicine, 2007, 07(6): 415-419. doi: Copy

1.	Liu XD, Yang YR, Lu YP, et al. Preoperative finasteride on decreasing operative bleeding during transurethral resection of prostate. Chinese Journal of Urology, 2003, 24(10): 694-696.
2.	Liu JJ, Cao J, Xu ZJ, et al. The effect of finasteride on bleeding associated with suprapubic prostatectomy and transurethral resection of prostate. Chinese Journal of Urology, 2001, 22(8): 490-492.
3.	Gu XQ, Ma QJ, Kong XB, et al. The effect of finasteride on VEGF and microvascular density in prostatic tissues. Chinese Journal of Gerontology, 2002, 22(4): 255-256.
4.	Zhang XL, Cui M. Epristeride. Chinese Journal of New Drugs, 2001, 10(1): 64.
5.	Xue ZY, Han WK, Jin J, et al. A multicentre clinical trail on epristeride for treatment of benign prostate hyperplasia. The Chinese Journal of Clinical Pharmacology, 2000, 16(6): 432-435.
6.	Chapter 1: diagnosis and treatment recommendations. J Urol, 2003, 170 (2 Pt 1): 530-547.
7.	Liu XD, Dong Q, Lu YP, et al. Effects of testosterone on VEGF and FLK-1 protein in expression in the ventral prostate of rat. Journal of Sichuan University (Medical Science Edition), 2002, 33(2): 226-228.
8.	Li GH, He ZF, Yu DM, et al. Effect of finasteride on intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate: a quantitative study. Journal of Zhejiang University(Medical Sciences), 2004, 33(3): 258-260.
9.	Donohue JF, Sharma H, Abraham R, et al. Transurethral prostate resection and bleeding: a randomized, placebo controlled trial of role of finasteride for decreasing operative blood loss. J Urol,2002,168(5): 2024-2026.
10.	李恭会, 何正富, 余大敏, 等. 非那雄胺对经尿道前列腺切除术中出血和冲洗液吸收影响的定量性研究. 浙江大学学报（医学版）,2004, 33(3): 258-260.
11.	Donohue JF, Hayne D, Karnik U, et al. Randomized, placebo-controlled trial showing that finasteride reduces prostatic vascularity rapidly within 2 weeks. BJU International, 2005, 96(9): 1319-1322.
12.	刘孝东, 杨宇如, 卢一平, 等. 非那雄胺减少TURP术中出血的机理研究.中华泌尿外科杂志, 2003,24(10): 694-696.
13.	柳建军, 曹军, 许志坚, 等. 非那雄胺对前列腺增生症术中及术后出血的治疗作用. 中华泌尿外科杂志, 2001, 22(8): 490-492.
14.	谷欣权, 马庆杰, 孔祥波, 等. 非那雄胺对前列腺血管内皮生长因子与微血管的影响. 中国老年学杂志, 2002,22(4): 255-256.
15.	张鲜利, 崔敏. 依立雄胺片. 中国新药杂志,2001, 10(1): 64.
16.	薛兆英, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生Ⅱ期临床研究.中国临床药理学杂志, 2000, 16(6): 432-435.
17.	AUA practice guidelines committee. AUA guideline on management of benign prostatic hyperp lasia (2003) .
18.	Puchner PJ, Miller MI. The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a preliminary report. J Urol,1995,154(5): 1779-1782.
19.	Lekas E, Bergh A, Damber JE. Effects of finasteride and bicalutamide on prostatic blood flow in the rat. BJU International, 2000, 85(7): 962-965.
20.	Foley SJ, Bailey DM. Microvessel density in prostatic hyperplasia. BJU International, 2000, 85(1): 70-73.
21.	Dulak J, Jozkowicz A, Dembinska-Kiec A, et al. Nitric oxide induces the synthesis of vascular endothelial growth factor by rat vascular smooth muscle cells. Arteriosclerosis, Thrombosis & Vascular Biology, 2000, 20(3): 659-666.
22.	刘孝东, 董强, 卢一平, 等. 睾酮对血管内皮生长因子及其受体在大鼠前列腺组织中表达的影响. 四川大学学报（医学版）, 2002, 33(2): 226-228.
23.	Hayek OR, Shabsigh A, Kaplan SA, et al. Castration induces acute vasoconstriction of blood vessels in the rat prostate concomitant with a reduction of prostatic nitric oxide synthase activity. J Urol, 1999, 162(4): 1527-1531.

1. Liu XD, Yang YR, Lu YP, et al. Preoperative finasteride on decreasing operative bleeding during transurethral resection of prostate. Chinese Journal of Urology, 2003, 24(10): 694-696.
2. Liu JJ, Cao J, Xu ZJ, et al. The effect of finasteride on bleeding associated with suprapubic prostatectomy and transurethral resection of prostate. Chinese Journal of Urology, 2001, 22(8): 490-492.
3. Gu XQ, Ma QJ, Kong XB, et al. The effect of finasteride on VEGF and microvascular density in prostatic tissues. Chinese Journal of Gerontology, 2002, 22(4): 255-256.
4. Zhang XL, Cui M. Epristeride. Chinese Journal of New Drugs, 2001, 10(1): 64.
5. Xue ZY, Han WK, Jin J, et al. A multicentre clinical trail on epristeride for treatment of benign prostate hyperplasia. The Chinese Journal of Clinical Pharmacology, 2000, 16(6): 432-435.
6. Chapter 1: diagnosis and treatment recommendations. J Urol, 2003, 170 (2 Pt 1): 530-547.
7. Liu XD, Dong Q, Lu YP, et al. Effects of testosterone on VEGF and FLK-1 protein in expression in the ventral prostate of rat. Journal of Sichuan University (Medical Science Edition), 2002, 33(2): 226-228.
8. Li GH, He ZF, Yu DM, et al. Effect of finasteride on intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate: a quantitative study. Journal of Zhejiang University(Medical Sciences), 2004, 33(3): 258-260.
9. Donohue JF, Sharma H, Abraham R, et al. Transurethral prostate resection and bleeding: a randomized, placebo controlled trial of role of finasteride for decreasing operative blood loss. J Urol,2002,168(5): 2024-2026.
10. 李恭会, 何正富, 余大敏, 等. 非那雄胺对经尿道前列腺切除术中出血和冲洗液吸收影响的定量性研究. 浙江大学学报（医学版）,2004, 33(3): 258-260.
11. Donohue JF, Hayne D, Karnik U, et al. Randomized, placebo-controlled trial showing that finasteride reduces prostatic vascularity rapidly within 2 weeks. BJU International, 2005, 96(9): 1319-1322.
12. 刘孝东, 杨宇如, 卢一平, 等. 非那雄胺减少TURP术中出血的机理研究.中华泌尿外科杂志, 2003,24(10): 694-696.
13. 柳建军, 曹军, 许志坚, 等. 非那雄胺对前列腺增生症术中及术后出血的治疗作用. 中华泌尿外科杂志, 2001, 22(8): 490-492.
14. 谷欣权, 马庆杰, 孔祥波, 等. 非那雄胺对前列腺血管内皮生长因子与微血管的影响. 中国老年学杂志, 2002,22(4): 255-256.
15. 张鲜利, 崔敏. 依立雄胺片. 中国新药杂志,2001, 10(1): 64.
16. 薛兆英, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生Ⅱ期临床研究.中国临床药理学杂志, 2000, 16(6): 432-435.
17. AUA practice guidelines committee. AUA guideline on management of benign prostatic hyperp lasia (2003) .
18. Puchner PJ, Miller MI. The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a preliminary report. J Urol,1995,154(5): 1779-1782.
19. Lekas E, Bergh A, Damber JE. Effects of finasteride and bicalutamide on prostatic blood flow in the rat. BJU International, 2000, 85(7): 962-965.
20. Foley SJ, Bailey DM. Microvessel density in prostatic hyperplasia. BJU International, 2000, 85(1): 70-73.
21. Dulak J, Jozkowicz A, Dembinska-Kiec A, et al. Nitric oxide induces the synthesis of vascular endothelial growth factor by rat vascular smooth muscle cells. Arteriosclerosis, Thrombosis & Vascular Biology, 2000, 20(3): 659-666.
22. 刘孝东, 董强, 卢一平, 等. 睾酮对血管内皮生长因子及其受体在大鼠前列腺组织中表达的影响. 四川大学学报（医学版）, 2002, 33(2): 226-228.
23. Hayek OR, Shabsigh A, Kaplan SA, et al. Castration induces acute vasoconstriction of blood vessels in the rat prostate concomitant with a reduction of prostatic nitric oxide synthase activity. J Urol, 1999, 162(4): 1527-1531.

Chinese Journal of Evidence-Based Medicine

Effect of Epristeride on Decreasing Intraoperative Bleeding During Transurethral Resection of Prostate

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