Assessment of Use of Cyproterone Acetate Preoperatively on TURP Outcome

Background: TURP is the ‘gold standard’ technique for managing BPH. Even within the era of lasers and bipolar va-pourisation systems, monopolar TURP is still widely used, especially in developing countries. Despite marked improve-ments in TURP techniques, bleeding is still one of the undesir-able perioperative events. Aim of Study: To evaluate the impact of pre-treatment with Cyproterone Acetate as an antiandrogen on blood loss during Transurethral Resection of Prostate (TURP). Patients and Methods: This study was designed to eval-uate the pre-operative use of CPA prior to TURP in patients with moderate size BPH. Urology Department, Ain Shams Uni-versity Hospitals and Minia General Hospital. From February 2018 to October 2018. This study was conducted on 40 patients diagnosed with BPH and are scedualed for TURP. The study was conducted on 40 patients who had TURP. They were di-vided randomly one by one into two equal groups. Group A: (Cyproterone acetate group). This included 20 patients who had Cyproterone acetate 50mg tab BID after meal for 2 weeks pri-or to TURP. Group B: (Control) 20 patients underwent TURP without preoperative administration of cyproterone acetate. Results: In our study we assessed the operative blood loss by comparing hemoglobin level before and 24 hours after the procedure. Our results showed that intraoperative bleeding was significantly reduced after CPA intake for 2 weeks before the surgery. There is also a significant reduction in microvessel density in prostatic tissue in the CPA group compared to the untreated group. Morever, Operative time was significantly re-duced in the CPA group in comparison to the untreated group and this is explained bya clearer operative field due to minimal bleeding, allowing more resection in less operative time with less blood loss. Conclusion: Cyproterone acetate can be safely used before transurethral resection of moderate sized prostate. Cyproterone acetate significantly decrease intraoperative bleeding as well as operative time as a result of its antiandrogenic action which lead to significant decrease in the microvessel density of the prostatic tissue.