Effects of preoperative dutasteride treatment in holmium laser enucleation of the prostate

Abstract

Objectives: To investigate factors influencing the degree of difficulty in finding and maintaining an appropriate plane on the surgical capsule of the prostate during holmium laser enucleation of the prostate. Methods: A total of 116 men undergoing holmium laser enucleation of the prostate for benign prostate hyperplasia between January 2010 and September 2013 at our hospital were included in this analysis. The degree of difficulty in finding and maintaining the plane of the surgical capsule of the prostate was retrospectively evaluated and graded by using video-based analysis according to newly defined criteria (gradeI, least difficult; gradeIV, most difficult). Factors influencing the degree of difficulty were investigated. Results: Video analysis was possible in 99 of 116 patients. Decapsulation difficulty in decapsulation was deemed as being gradeI in 32 patients, gradeII in 31 patients, gradeIII in 20 patients and gradeIV in 16 patients. Preoperative dutasteride therapy was the only factor associated with an increasing level of difficulty in decapsulation during holmium laser enucleation of the prostate. Conclusions: Although preoperative dutasteride therapy effectively reduces intraoperative blood loss, surgeons with limited experience should be careful with the use of dutasteride, because its administration might increase surgical difficulty during holmium laser enucleation of the prostate.