Perioperative Use of Cyproterone Acetate with Transurethral Resection of Large Prostate: Preliminary Results.

Journal of endourology / Endourological Society

PubMedID: 25316503

El-Gamal OM, Gameel TA, Ghoneem A, Soliman MG, Abo El-Enen M, Abo El-Hitham A, El-Rasheedy M, Elnady MA, Sabaa M. Perioperative Use of Cyproterone Acetate with Transurethral Resection of Large Prostate: Preliminary Results. J Endourol. 2014;.
Purpose: To assess the impact of short-term treatment with cyproterone acetate (CPA) on intraoperative and early postoperative complications of transurethral resection of relatively large prostate. Patients and methods: We recruited patients with prostate size of 60-90 g and randomized them into two equal groups. The first one had 50 mg of CPA bds for two weeks before the operation and maintained it for an extraweek postoperatively. The other group received placebo. All patients underwent monopolar transurethral prostatectomy (M-TURP) and the prostatic chips were stained for CD34 specific for nascent blood vessels. Results: Ninety-five patients were included. Mean patient age was 60.88± 2.5 years and mean prostate size was 72.76±7.21 g. Cyproterone acetate was well tolerated with no serious adverse effects. The mean resection time and the mean weight of the resected tissue were comparable between the two groups. Intraoperative blood loss, fluid absorption and blood loss per gram of resected tissue (259.47±78.27 ml, 787.38±300.56 ml & 14,87±4.02 ml/g and 327.25± 98.97 ml, 937.4±350.2 ml & 17.08±5.55 ml/g respectively) were significantly lower in the treatment group (p<0.05). In addition, excessive postoperative bleeding was encountered in one case in the treatment group and in seven in the control (p<0.05). Lastly, the histopathological study revealed that the mean microvessel density (MVD) in each of the suburethral portion and the hyperplastic nodules of the prostate were significantly lower in the CPA group (p<0.001). Conclusion: The perioperative use of CPA with M-TURP of relatively large prostate may help in decreasing the perioperative bleeding and fluid absorption that usually take placeduring this procedure.