Kirlus Farag
Objective
To evaluate the impact of pre-treatment with Cyproterone Acetate as an antiandrogen on blood loss during TURP in moderate size prostate.
Patients and Methods: Urology department - Ain Shams University hospitals and Minia General Hospital. From February 2018 to October 2018. This study was conducted on 40 patients scheduled for TURP. They were divided randomly one by one into two equal groups. Group A: (Cyproterone acetate group). This included 20 patients who had Cyproterone acetate 50mg tab BID after meal for 2 weeks prior to TURP. Group B: (control) 20 patients underwent TURP without preoperative administration of cyproterone acetate. IRP approval obtained.
Results
In our study we assessed the operative blood loss by comparing haemoglobin level before and 24 hours after the procedure. Our results showed that intraoperative bleeding was significantly reduced after CPA intake for 2 weeks before the surgery. There is also a significant reduction in microvessel density in prostatic tissue in the CPA group compared to the untreated group. Moreover, Operative time was significantly reduced in the CPA group in comparison to the untreated group and this is explained by a clearer operative field due to minimal bleeding, allowing more resection in less operative time with less blood loss.
Conclusion
Cyproterone acetate can be safely used before transurethral resection of moderate sized prostate. Cyproterone acetate significantly decrease intraoperative bleeding as well as operative time as a result of its antiandrogenic action which lead to significant decrease in the microvessel density of the prostatic tissue.
Authors
Kirlus Farag
United Lincolnshire Teaching Hospitals, Lincoln, United Kingdom