scholarly journals The effect of short-term use of finasteride versus cyproterone acetate on perioperative blood loss with monopolar transurethral resection of prostate

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Shabieb A. Abdelbaki ◽  
Adel Al-Falah ◽  
Mohamed Alhefnawy ◽  
Ahmed Abozeid ◽  
Abdallah Fathi
Keyword(s):  
Blood Loss ◽  
Transurethral Resection ◽  
Cyproterone Acetate ◽  
Histopathological Examination ◽  
Microvascular Density ◽  
Controlled Study ◽  
Control Group ◽  
Transurethral Resection Of Prostate ◽  
Perioperative Bleeding ◽  
And Control

Abstract Background 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.

Safety and efficacy of intraoperative administration of intravenous tranexamic acid in transurethral resection of prostate: A double-blind, randomised, placebo-controlled trial

2019 ◽  
Vol 13 (2) ◽  
pp. 125-131
Author(s):  
Behrooz Karkhanei ◽  
Seyyed Habibollah Musavi-Bahar ◽  
Masume Bayat ◽  
Kaveh Kaseb ◽  
Haress Rezaee ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Transurethral Resection ◽  
Controlled Trial ◽  
Operation Time ◽  
Control Group ◽  
Transurethral Resection Of Prostate ◽  
Prostate Weight ◽  
The Mean ◽  
And Control ◽  
Surgeon Satisfaction

Purpose: The purpose of this article is to evaluate and compare the effect of intravenous tranexamic acid (TXA) with placebo on haemorrhage and quality of vision during and post-transurethral resection of the prostate (TURP). Methods: For nine months (September 2016 until June 2017), a randomised clinical trial was conducted with 70 patients, age 50–80 years, who were included in the study according to inclusion criteria (patients who required surgical intervention because of benign prostatic hyperplasia, prostate weight (<100 cc), American Society of Anesthesiologists score ⩽II, etc.) and enrolled randomly one to one in two study groups, and who underwent TURP in Shahid Beheshti Hospital of Hamadan University of Medical Sciences by a single surgeon. Interventions: The study group participants received 500 mg TXA in 500 ml ringer serum (concentration of 1 mg/ml, infusion rate 100 mg/min, maximum dose of 15 mg/kg), whereas the control group received only ringer serum during surgery. The results were then compared for the variables operation time, amount of haematocrit (HCT)-haemoglobin (Hb) reduction following surgery and surgeon satisfaction. Results: Both groups had no difference in age, weight and prostate weight. Surgeon satisfaction was evaluated at the end of the operation. The frequency of high satisfaction in case and control groups was 74.3% and 8.65%, whereas low satisfaction was 0% and 42.69%, respectively ( p < 0.05). The mean time of operation was 53.57±16.43 vs 120.71±47.76 minutes in the case and control group, respectively ( p < 0.05). The mean HCT-Hb decrease ( p = 0.00) and the amount of infused volume before and after the operation ( p = 0.03) between both groups were significantly different. None of the patients experienced TXA side effects. Conclusions: Intravenous TXA can prevent haemorrhage and higher Hb and HCT reduction following TURP, shortening the operation time and improving surgeon vision during TURP. Level of evidence: 1b

scholarly journals Role of dutasteride (5-alpha-reductase inhibitor) in patients undergoing transurethral resection of prostrate

2018 ◽  
Vol 6 (8) ◽  
pp. 2667
Author(s):  
Shafeen Majid Koul ◽  
Imtiaz Shah ◽  
Omer Khursheed ◽  
Shehwar Majid Koul ◽  
Momin Shah
Keyword(s):  
Blood Loss ◽  
Transurethral Resection ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Prostate Hyperplasia ◽  
Reductase Inhibitors ◽  
Perioperative Bleeding ◽  
Surgical Bleeding ◽  
Surgical Treatments

Background: Bladder outflow obstruction due to benign prostate hyperplasia is the commonest urological condition affecting men over 50 years of age. Medical therapy is usually the first line management of BPH. The most frequent complication is encountered is perioperative bleeding and postoperative bleeding. Preoperative use of 5-alpha-reductase inhibitors like dutasteride to reduce surgical bleeding is still a topic of debate. The aim of this study was to evaluate whether pretreatment with dutasteride for 4 weeks prior to surgery can reduce surgical blood loss as well as post op blood loss and complications.Methods: A total of 60 patients with BHP who were to undergo TURP were enrolled and randomized into 2 groups. The dutasteride group consisted of 30 patients who were treated with dutasteride (0.5mg) for 4 weeks before surgery and the control group consisted of 30 patients.Results: The preoperative hemoglobin levels of cases and controls was done followed by postoperative hemoglobin. The average fall in hemoglobin was 0.9mg/dl in cases and 2.1mg/dl in controls. Concluding that group of patients taking dutasteride (cases) peri and post-operative surgical bleeding was significantly reduced on pretreatment of dutasteride for 4 weeks before TURP.Conclusions: Many other surgical treatments are being developed for BHP, but TURP is the gold standard treatment. However, morbidity and blood loss are major potential complications and taking dutasteride 4 weeks prior to transurethral resection of prostrate can be effective in reducing its complications.

scholarly journals The Effect of Dutasteride in Peri-Operative Blood Loss During Transurethral Resection of Prostate (Turp)

2020 ◽  
Vol 22 (2) ◽  
pp. 177-181
Author(s):  
Md Mostafizur Rahaman ◽  
Md Habibur Rahman ◽  
Muhammad Hossain ◽  
Md Saiful Islam ◽  
Mohammad Shafiqur Rahman
Keyword(s):  
Blood Loss ◽  
Transurethral Resection ◽  
Statistical Significance ◽  
Control Group ◽  
Transurethral Resection Of Prostate ◽  
Double Blind ◽  
Significant Difference ◽  
Group B ◽  
Group Control Group ◽  
Experimental Group

This prospective double blind comparative study was designed to compare the effect of Dutasteride on the perioperative blood loss in Transurethral Resection of Prostate (TURP).Sixty patients with BPH underwent TURP were divided into 2 groups. Patients belong to the group B (Control) and group A (Experimental). Experimental group patients were given Cap. A (dutasteride 0.5 mg) before two weeks of TURP and group B (control) were given Cap. B (placebo). Postoperative comparison between two groups showed that there were no significant difference between the weight of resected prostatic tissue (control =22.41±6.83 gm, and experimental = 25.38±7.22 gm; p=0.107). Postoperative hemoglobin level of both group (Control group = 10.78±0.64 gm/dL and experimental group = 10.83±.51 gm/dL) revealed no significant difference (p=0.774). The mean hemoglobin loss per gram of prostate tissue in both groups (control = 1.81±0.81 gm/gm and experimental = 1.79±0.88 gm/gm) did not show any statistical difference (p=0.938). In this the study it was found that if the BPH patients are subjected with dutasteride 0.5mg before 2 weeks of TURP, bleeding decrease slightly (Control group = 20.35±7.99 ml/gm and Experimental groups = 17.41±7.70 ml/gm). However, these data of bleeding loss did not show any statistical significance. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.177-181

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

scholarly journals Randomized, Double-Blind, Placebo-Controlled Study of Modified Erzhi Granules in the Treatment of Menopause-Related Vulvovaginal Atrophy

2018 ◽  
Vol 2018 ◽  
pp. 1-15
Author(s):  
Ranran Chen ◽  
Dianrong Song ◽  
Wei Zhang ◽  
Guanwei Fan ◽  
Yingqiang Zhao ◽  
...  
Keyword(s):  
Drug Withdrawal ◽  
Endometrial Thickness ◽  
Vaginal Epithelium ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Vulvovaginal Atrophy ◽  
Normal Ranges ◽  
And Control

Objective. To evaluate the clinical therapeutic efficacy and safety of modified Erzhi granules (MEG) in patients with menopause-related vulvovaginal atrophy (VVA). Methods. This randomized, double-blind, placebo-controlled study comprised two groups, including the treatment and control groups. Patients receive MEG and placebo for 12 weeks, respectively. Vaginal health score (VHS), vaginitis score, vaginal maturation index (VMI), female sexual function index (FSFI), and modified Kupperman Index (modified KI) were used as efficacy endpoints and assessed at baseline, 4, 8, and 12 weeks during administration, and 4 weeks after drug withdrawal. At baseline and 12 weeks, serum estradiol (E2), follicle stimulating hormone (FSH), pelvic ultrasound, breast ultrasound, and other safety parameters were measured, recording adverse events. Results. At 12 weeks, VHS, percentage of superficial cells in the vaginal epithelium and FSFI were significantly increased, while vaginitis score, percentage of basal cells in the vaginal epithelium, and modified KI were significantly decreased in comparison with baseline and control group (all P<0.05); these differences persisted for up to 4 weeks after drug withdrawal. The placebo group showed no significant change during treatment compared with baseline values (p>0.05). Serum E2 and FSH levels, endometrial thickness, and breast thickness in all patients were within the normal ranges before and after treatment, with no serious adverse reactions observed. Conclusion. MEG significantly alleviates menopause-related vulvovaginal atrophy, with no overt adverse effects on the endometrium, breast, hepatic, and renal functions.

scholarly journals NI-11 PATHOLOGICAL ASSESSMENT IN THE IMPACT OF ONE-SHOT BEVACIZUMAB ON UPTAKE OF 11C-METHIONINE

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii27-ii28
Author(s):  
Takaaki Beppu ◽  
Yuichi Sato ◽  
Kuniaki Ogasawara
Keyword(s):  
Amino Acid ◽  
Microvascular Density ◽  
Control Group ◽  
Tumor Removal ◽  
Histological Changes ◽  
Positron Emission ◽  
Newly Diagnosed Glioblastoma ◽  
And Control ◽  
The Impact ◽  
Single Intravenous Administration

Abstract BACKGROUND This study aimed to clarify how one-time administration of bevacizumab (BEV) changes histological features in glioblastoma, and how histological changes affect the uptake of 11C-methyl-L-methionine (11C-met) as an amino-acid tracer. MATERIALS AND METHODS Subjects were 18 patients with newly diagnosed glioblastoma who were assigned to 2 groups: BEV group, single intravenous administration of BEV before surgical tumor removal; and control group, surgical tumor removal alone. After surgery, we compared the densities of tumor cells and microvessels, and microvascular structures including vascular pericytes and L-type amino acid transporter-1 (LAT1), between the BEV and control groups. Correlations between 11C-met uptake on positron emission tomography before surgery, microvascular density, and LAT1 expression were assessed in each group. RESULTS BEV induced significant reductions in microvascular density, while tumor cell density and proliferation were retained in the BEV group. Percentages of vessels with pericytes and vascular endothelium with LAT1 expression were lower in the BEV group than in controls. Uptake of 11C-met correlated significantly with microvascular density in the BEV group, but not with LAT1expression. CONCLUSIONS The present study showed that even one course of BEV administration induced reductions in microvessels, vascular pericytes, and LAT1 expression in glioblastomas. One course of BEV therapy also reduced 11C-met uptake, which might have been largely attributed to reductions in microvessels rather than reductions in LAT1 expression, in addition to reduction of vascular permeability.

scholarly journals Application of Zizao Yangrong Granules for Treating Targeted Drugs–Related Skin Xerosis: A Randomized Double-Blinded Controlled Study

2020 ◽  
Vol 19 ◽  
pp. 153473542092483
Author(s):  
Yan Mei Peng ◽  
Hua Duan ◽  
Jingyi Zhang ◽  
Chenyao Sun ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Group ◽  
Growth Factor Receptor ◽  
Controlled Study ◽  
Control Group ◽  
Targeted Drugs ◽  
Liver And Kidney ◽  
Double Blinded ◽  
And Control

Background: Dermatologic toxicities are the most common side effects associated with the targeted drugs epidermal growth factor receptor inhibitors (EGFRIs), in which xerosis commonly complicated by pruritus severely disturbs the quality of life. The study has observed the curative effect of Zizao Yangrong granules (ZYG) from Chishui Xuanzhu in the treatment of EGFRIs-related xerosis and pruritus, as well as evaluating the safety of the prescription. Methods: Patients (n = 68) who had xerosis after using EGFRIs were enrolled and then randomly divided into the treatment group and control group, respectively, receiving ZYG and placebo granules combined with vitamin E ointment. The intervention lasted 4 weeks. Changes in xerosis and pruritus were observed, and blood routine examination as well as liver and kidney function are observed as safety indexes. The water content of skin and qualify of life were observed. Results: A total of 66 out of 68 patients finished the study with 34 patients in each group. The effective rates of xerosis among the treatment group and control group were 84.8% and 69.7% after 2 weeks’ treatment ( P < .05), while they were 84.8% and 75.8% after 4 weeks’ treatment ( P < .05). The patients in the experimental group had better quality of life than that in the control group ( P = .045). Conclusion: ZYG can effectively improve the skin dryness associated with EGFRIs, and significantly improve the quality of life of patients with good safety; however, larger randomized controlled trials are needed to verify these findings.

scholarly journals Perioperative blood loss in total hip and knee arthroplasty: Outcomes associated with intravenous tranexamic acid use in an academic medical center

2016 ◽  
Vol 4 ◽  
pp. 205031211663702 ◽  
Author(s):  
Craig A Hogan ◽  
Larry K Golightly ◽  
Suzanne Phong ◽  
Michael R Dayton ◽  
Clark Lyda ◽  
...  
Keyword(s):  
Treatment Group ◽  
Blood Loss ◽  
Confidence Interval ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Control Groups ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
And Control

Objectives: Clinical trials have reported decreased blood loss with the use of tranexamic acid during joint reconstruction. The purpose of this study was to assess the individual practice implications of tranexamic acid use in joint replacement surgery. Methods: Health records of adults undergoing total knee arthroplasty and total hip arthroplasty over a 12-month period were retrospectively reviewed. The treatment group comprised patients who received intravenous tranexamic acid perioperatively. The control group comprised patients who did not receive tranexamic acid. Results: Patients in the treatment group (n = 64) and the control group (n = 99) were well matched for demographics, orthopedic diagnosis, and comorbidities. In-hospital postsurgical mean decreases in hemoglobin concentrations were −4.05 g/dL and −4.94 g/dL in the treatment and control groups, respectively (p < 0.001). Postsurgical mean decreases in hematocrit levels were −11.2% and −14.2% in the treatment and control groups, respectively (p < 0.001). Three patients in the treatment group (5%) and 21 patients in the control group (21%) received red blood cell transfusions (p = 0.006). As compared to control, the relative risk of transfusion in the treatment group was 0.23 (95% confidence interval = 0.07–0.76) and the number needed to treat to avoid one transfusion was 7.0 (95% confidence interval = 3.8–14.4). No evidence of thromboembolism or other serious complications were observed in either group. Conclusions: In patients undergoing joint replacement surgery, perioperative administration of tranexamic acid was associated with diminished blood loss and lesser resource utilization.

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