The Effect of Two Weeks Preoperative Finasteride Therapy in Reducing Prostate Vascularity.

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.