AB017. SOH25_AB_342. The role of preoperative finasteride in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials
Urology Session

AB017. SOH25_AB_342. The role of preoperative finasteride in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials

Cian Hehir1,2, Gavin Calpin1, Gordon Daly1,2, Gavin Dowling1, Niall Davis2

1Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Urology, Beaumont Hospital, Beaumont, Dublin, Ireland

Background: Transurethral resection of the prostate (TURP) remains the gold standard in surgical management of patients with symptomatic benign prostatic hyperplasia (BPH). The vascularity of the prostate presents a challenge in terms of intraoperative bleeding and surgical field visualisation. This study aims to evaluate the role of preoperative finasteride in TURP with respect to blood loss, mean vascular density (MVD) and perioperative complications.

Methods: A systematic search was performed in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify randomised controlled trials (RCTs) evaluating the effect of finasteride in TURP published until November 2024. Studies were screened by two independent researchers. Data were exported and analysed using RevMan© 5.4.

Results: Nineteen RCTs met the inclusion criteria for this meta-analysis in which a total of 1,655 patients underwent TURP for BPH. There was significantly less intraoperative bleeding in the finasteride. This decrease in blood loss remained significant when normalised with respect to resection weight (mL/g). Hence, finasteride resulted in a significantly lower risk of blood transfusion. Finasteride was also associated with decreased MVD, lower risk of postoperative acute urinary retention and shorter operative duration, but these did not reach statistical significance.

Conclusions: Preoperative administration of finasteride is safe and effective in reducing intraoperative blood loss. The mechanism for decreased blood loss in the finasteride cohort is likely owed to the effect of finasteride on glandular vascularity, although this relationship did not reach statistical significance in this meta-analysis.

Keywords: Transurethral resection; prostate; finasteride; postoperative complications; blood loss

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab017
Cite this abstract as: Hehir C, Calpin G, Daly G, Dowling G, Davis N. AB017. SOH25_AB_342. The role of preoperative finasteride in transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials. Mesentery Peritoneum 2025;9:AB017.

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