title: A Systematic Review and Meta-Analysis of the Effects on Dutasteride Treatment for Reducing Surgical Blood Loss during Transurethral Resection of the Prostate.
abstract: OBJECTIVE
  This systematic review and meta-analysis were performed to evaluate the efficacy of preoperative dutasteride treatment for reducing surgical blood loss in patients undergoing transurethral resection of the prostate (TURP).
  
  
  METHODS
  A systematic search was performed from the electronic databases including PubMed, EMBASE, and Cochrane Library by May 2016. We followed the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis statement when examining the literature. Identified articles were strictly appraised for quality and relevance.
  
  
  RESULTS
  Five randomized controlled trials (RCTs) and 5 retrospective cohort studies involving 1,022 patients with benign prostate hyperplasia were analyzed based on the inclusion criteria. Pooled analysis revealed that preoperative treatment with dutasteride had a significantly smaller decrease in hemoglobin (weighted mean difference [WMD] -0.47, 95% CI -0.70 to -0.24, p < 0.0001) and hematocrit levels (WMD -1.03, 95% CI -1.73 to -0.33, p = 0.004); However, no signiﬁcant difference has been found in terms of the total blood loss during TURP and blood loos per gram of resected prostatic tissue, the weight of resected prostate tissue, the microvessel density of the prostate, and the transfusion rate between the dutasteride and the control group.
  
  
  CONCLUSIONS
  This systematic review and meta-analysis indicate that preoperative treatment with dutasteride could reduce surgical bleeding during TURP, but the findings of this study should be further confirmed by well-designed prospective RCTs with a larger patient series.
authors.affiliation: Department of Urology, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ren
authors.forename: Shicong
authors.initials: S
authors.lastname: Lai
authors.forename: Zhaoqiang
authors.initials: Z
authors.lastname: Jiang
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Tongxiang
authors.initials: T
authors.lastname: Diao
authors.forename: Nikesh
authors.initials: N
authors.lastname: Thiruchelvam
authors.forename: Guan
authors.initials: G
authors.lastname: Zhang
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000494:pharmacology; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D000068538:Dutasteride / Q000494:pharmacology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008833:Microcirculation; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D058891:5-alpha Reductase Inhibitors; D006454:Hemoglobins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068538:Dutasteride
keywords: Benign prostatic hyperplasia; Dutasteride; Intraoperative blood loss; Meta-analysis; Transurethral resection of the prostate