title: Goserelin acetate before transurethral resection of moderately enlarged benign prostatic hyperplasia: Prospective randomised-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin acetate (GA), on surgical blood loss during transurethral resection of the prostate (TURP), as well as its histopathological effect on prostatic microvessel density (MVD).
  
  
  METHODS
  Patients who underwent TURP due to benign prostatic enlargement (60-100 mL) were randomly subdivided into two equal groups according to whether they received preoperative GA administration (3.6 mg; group A) or not (group B). Evaluation parameters were operative time, weight of resected prostatic tissue, perioperative haematocrit (HCT) changes, estimation of intraoperative blood loss, and suburethral and stromal prostatic MVD. Effects of GA on prostate weight and any possible side-effects were also monitored.
  
  
  RESULTS
  In all, 35 and 33 patients were included in groups A and B, respectively. Operative time and HCT values' changes were significantly less in group A (P < 0.05). Also, operative blood loss (both total and adjusted per weight of resected tissue) was lower in group A, at a mean (SD) of 178.13 (77.71) mL and 3.74 (1.52) mL/g vs 371.75 (91.09) mL and 8.59 (2.42) mL/g (P < 0.001). The median MVD in both suburethral [8 vs 11 vessels/high-power field (HPF)] and stromal tissues (9 vs 17 vessels/HPF) were significantly lower in group A (P < 0.001). Side-effects were minimal.
  
  
  CONCLUSIONS
  A single dose of GA, a LHRH agonist, before TURP is safe and effective in reducing surgical blood loss. It significantly reduced MVD in both suburethral and stromal nodular prostatic tissues without regional discrepancy.
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abo El-Enen
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Tawfik
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: El-Abd
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Maged
authors.initials: M
authors.lastname: Ragab
authors.affiliation: Departments of Histology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Sherin
authors.initials: S
authors.lastname: El-Abd
authors.affiliation: Departments of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elrashidy
authors.affiliation: Departments of Medical Oncology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Nehal
authors.initials: N
authors.lastname: Elmashad
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rasheed
authors.affiliation: Departments of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Shawky
authors.initials: S
authors.lastname: El-Abd
keywords: 5ARI, 5α-reductase inhibitor; BPE, benign prostatic enlargement; BPH; Blood loss; CBC, complete blood count; DHT, dihydrotestosterone; GA, goserelin acetate; Goserelin; HCT, haematocrit; HPF, high-power field; LHRH; MVD, microvessel density; MVD-stroma, stromal MVD; MVD-sub, suburethral MVD; TRUS-PV, TRUS prostate volume; TURP; VEGF, vascular endothelial growth factor