title: Effects of preoperative dutasteride treatment in holmium laser enucleation of the prostate.
abstract: OBJECTIVE
  To investigate factors influencing the degree of difficulty in finding and maintaining an appropriate plane on the surgical capsule of the prostate during holmium laser enucleation of the prostate.
  
  
  METHODS
  A total of 116 men undergoing holmium laser enucleation of the prostate for benign prostate hyperplasia between January 2010 and September 2013 at our hospital were included in this analysis. The degree of difficulty in finding and maintaining the plane of the surgical capsule of the prostate was retrospectively evaluated and graded by using video-based analysis according to newly defined criteria (grade I, least difficult; grade IV, most difficult). Factors influencing the degree of difficulty were investigated.
  
  
  RESULTS
  Video analysis was possible in 99 of 116 patients. Decapsulation difficulty in decapsulation was deemed as being grade I in 32 patients, grade II in 31 patients, grade III in 20 patients and grade IV in 16 patients. Preoperative dutasteride therapy was the only factor associated with an increasing level of difficulty in decapsulation during holmium laser enucleation of the prostate.
  
  
  CONCLUSIONS
  Although preoperative dutasteride therapy effectively reduces intraoperative blood loss, surgeons with limited experience should be careful with the use of dutasteride, because its administration might increase surgical difficulty during holmium laser enucleation of the prostate.
authors: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors: Ryo
authors: R
authors: Sato
authors: Yuko
authors: Y
authors: Sadaoka
authors: Kojiro
authors: K
authors: Nishio
authors: Yoshitomo
authors: Y
authors: Kobori
authors: Hiroshi
authors: H
authors: Yagi
authors: Gaku
authors: G
authors: Arai
authors: Shigehiro
authors: S
authors: Soh
authors: Hiroshi
authors: H
authors: Okada
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects*; D000368:Aged; D004210:Dissection; D000068538:Dutasteride / Q000009:adverse effects*; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011300:Preoperative Care; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D014563:Urodynamics; D014741:Video Recording
chemical_list: D058891:5-alpha Reductase Inhibitors; D000068538:Dutasteride
keywords: dutasteride; laser therapy; magnetic resonance imaging; prostate; urological surgical procedures