RESUMO
Objective: To determine the effect of two weeks preoperative finasteride therapy in reducing prostate vascularity in terms of mean microvessel density [MVD] and expression of VEGF in prostate urothelium among patients of BPH by comparing with controls. Study Design: Randomized controlled trial. Place and Duration of Study: Shifa International Hospital, Islamabad, from January 2013 to January 2014
Methodology: A total of 80 patients of Benign Prostatic Hyperplasia [BPH] planned for Trans-Urethral Resection of Prostate [TURP] having prostate size of more than 40 grams on trans-abdominal ultrasonography was randomized into two groups, each group having 40 patients. The finasteride group [Group A] was prescribed oral 5 mg of finasteride daily for 2 weeks before surgery. The control group [Group B] did not receive any agent. After 2 weeks, TURP was performed and prostate samples were sent for histopathological determination of MVD and expression of VEGF
Results: The mean age of patients was 66.21 +/- 10.08 years, ranging from 48 to 86 years. The mean prostate gland size was comparable in both groups [55 +/- 10.7 vs. 58.1 +/- 10.8 grams, p=0.21]. Mean MVD in finasteride group [20.25 +/- 10.3] was significantly lower as compared to control group [48.9 +/- 22.6, p < 0.001]. Similarly expression of VEGF was also significantly lower in finasteride group [30%] as compared to control group [65%] [p= 0.0017]. Mean MVD had a significant weak correlation with the size of prostate gland on Pearson correlation test [2-tailed] with r = 0.222
Conclusion: Finasteride reduces microvessel density and hence prostate vascularity with only 2-week therapy and the mean MVD is clearly correlated with size of prostate