Effect of high-dose finasteride combined with transurethral plasmakinetic resection of prostate on prostatespecific antigen and inflammatory factors in patients with benign prostatic hyperplasia
Purpose: To ascertain the effect of perioperative application of high-dose of finasteride on prostatespecific antigen (PSA) in serum, tumor necrosis factor α (TNF-α) and interleukin-1β (IL-1β) in prostatic fluid of prostatic hyperplasia (BPH) patients with transurethral plasmakinetic resection of prostate (PKRP).
Methods: In total, 141 BPH patients treated with PKRP in Hunan Provincial People’s Hospital, Changsha City, China from January 2015 to January 2017 were randomly divided into three groups of 47 cases each, viz, high-dose (10 mg of finasteride), low-dose (5 mg of finasteride), control (0 mg of finasteride). The levels of PSA in serum, as well as the levels of TNF-α and IL-1β in prostatic fluid were evaluated 7 days before and after surgery. Re-bleeding within 3 months after surgery in the three groups were performed and the patients observed.
Results: Intra-operative bleeding volume, bleeding volume per unit resected tissue, and intra-operative volume of rinsing fluid were significantly less in high- and low-dose groups than those in the control group (p < 0.05); furthermore, the operation time was significantly shorter than that for the control group (p < 0.05). Seven days after surgery, international prostate symptom score (IPSS), serum PSA, and TNF-α and IL-1β in prostatic fluid of the high- and low-dose groups were significantly lower than those of the control group (p < 0.05). Also, maximum urine flow rate was significantly higher than that of the control group. Serum PSA, and TNF-α and IL-1β levels in prostatic fluid were significantly lower than those of low-dose group (p < 0.05). Serum PSA as well as TNF-α and IL-1β levels in prostatic fluid were positively correlated with IPSS score (r = 0.817, 0.838, 0.859, p < 0.001). The admission rate due to rebleeding was lowest in the high-dose group, followed by the low-dose group.
Conclusion: Finasteride combined with PKRP for BPH acts synergistically to reduce serum PSA levels and local inflammatory reaction. High-dose finasteride/PKRP combination is more efficacious than the low-dose combination, thereby improving short-term prognosis in patients.
Keywords: Finasteride, Transurethral plasmakinetic resection, Prostate, Prostate-specific antigen, Inflammatory factors