The Meta-anlysis Of Effect Of Finasteride Therapy On Preoperative Bleeding In Patients Who Were Candidates For Transurethral Resection Of The Prostate

Objectives: The primary aim was to assess the efficacy of hemorrhage in TURP with the therapy of finasteride or with placebo , including Peroperative bleeding, Bleeding per resected gram of prostate tissue and Prepostoperative Hb decrease.Methods: According to the Cochrane reviewer's handbook, included studies were those on patients with BPH experiencing TURP. The search strategy was developed according to the Collaborative Review Group search strategy. Medline, Embase, CBM, Cochrane library, articles in the academic degree collections were searched for clinic trails comparing efficacy of hemorrhage in TURP with the therapy of finasteride or with placebo. In addition, the reference articles of each selected trial were hand-searched. Trials of RCT would be assessed for quality according to the concealment of treatment allocation, blinding of patients and outcome assessors, adequate descriptions of numbers and reasons for patient withdrawl and graded their methodologic quality according to the method of Jadad. Trials of NRCT would be assessed for quality according to the method of Jiangping Liu, Stroup and Hailey. Data would be extracted from each identified paper independently by two reviewers and would include the information on the trial design, participant, type of intervention and outcome measures. The Revman 4.2 provided by the Cochrane collaboration was used to review management and analysis. The results were expressed as Odds ratio (OR) and 95% confidence internals (CI) for dischotomous outcomes and weighted mean difference (WMD) and 95% CI for continuous outcomes. Data was pulled using fixed effect model or random effect model according to their homogeneity or heterogeneity. Chi-square tests for heterogeneity would be performed and sensitivity analysis would be undertaken if considered appropriate.Result: Eleven related articles were searched and only five were included in our systematic review. Four articles are high quality RCT, the other one is a NRCT. Four articles are C grade and one is B grade according to the quality evaluation of methodology. the efficacy for hemorrhage in TURP with the therapy of fmasteride or with placebo was assessed by means of comparing the Peroperative bleeding, Bleeding per resected gram of prostate tissue and Prepostoperative Hb decrease after comparing the age,IPSS,PSA, preoperative volume of prostate , preoperative Hb and the excision volume.The outcome of mata-anlysis revealed that when the the age (66.9+/-9.43₆6.3+/-5.18 P>0.05), IPSS(12.48+/-2.45₁4.25+/-2.15P> 0.05), PSA(2.43+/-2.10₃.05+/-2.07 P>0.05),preoperative volume of prostate , and the excision volume were balanced the Peroperative bleeding (WMD =-85.44, WMD 95%CI -117.31, -53.58), Bleeding per resected gram of prostate tissue (WMD =-3.5, WMD 95%CI -6.34, -0.58)and Prepostoperative Hb decrease(WMD=-1.61, WMD 95%CI -1.96, -1.26) of experimental group were obviously lower than those of control group.Conclusion: efficacy of hemorrhage in TURP with the therapy of finasteride or with placebo:the hemorrhage of TURP was obviously decreased with preoperative use of finasteride.