***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: In this preliminary , r and omized study , 35 men were pretreated for 3 months with finasteride or placebo before transurethral resection of the prostate .  The study was inconclusive because it did not show any benefit in terms of reducing perioperative bleeding during or after the resection but there is a need for a large , prospect i ve , r and omized study Objective . To evaluate the effects of short term use of dutasteride and Serenoarepens before transurethral resection of the prostate ( TURP ) on the amount of intraoperative blood loss and microvessel density ( MVD ) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia . Patients and methods . The study involved 75 male patients who planned to have a TURP . The patients were r and omly divided into three groups . The control group comprised 21 patients . Group 2 comprised 27 patients who used dutasteride 5 mg/day , and group 3 comprised 27 patients who used S. repens 160 mg/day for 5 weeks before the operation . The amount of intraoperative haemorrhage was calculated . Total blood loss , total blood loss/time , total blood loss/weight of resected tissue and total blood loss/weight/time were calculated for each patient and all were recorded . Sections from the prostatic stromal and suburethral tissues were examined for suburethral and prostatic MVD . Results . The total amount of intraoperative blood loss , total blood loss/time , total blood loss/weight of resected tissue , total blood loss/weight/time , serum haemoglobin level change , prostatic MVD and suburethral MVD of the groups were compared . No significant statistical differences were found between the groups for any of these variables ( p > 0.05 ) . Conclusions . Dutasteride and S. repens therapies were not superior to control in terms of the decrease in total blood loss during TURP . Moreover , MVD showed no statistical differences in the treatment groups compared with the control group OBJECTIVES To determine the long-term effects of finasteride treatment on prostate tissue composition ; to relate these effects to clinical outcomes ; and to test the hypothesis that finasteride exerts a selective or preferential action on the transition zone . METHODS Nineteen men with symptomatic benign prostatic hyperplasia ( BPH ) who completed a 6-month double-blind trial of finasteride  were enrolled in a 24-month open-label extension study of drug responders . Magnetic resonance imaging and prostate biopsy for morphometric analysis were performed together 70 times : at baseline ( n = 19 ) , after treatment periods of intermediate duration ( 6 to 18 months , n = 32 ) , and after long-term drug treatment ( 24 to 30 months , n = 19 ) . At baseline , prostate volume averaged 51 cc , of which 57 % was transition zone . RESULTS Decreases in symptom score , dihydrotestosterone and prostate-specific antigen levels , and prostate volume occurred at 6 months ( P < 0.01 ) , stabilized , and were maintained without further long-term decreases . Prostate epithelium contracted progressively from baseline ( 19.2 % tissue composition ; 6.0-cc volume ; 3.2 stroma/epithelial ratio ) to intermediate ( 12.5 % , 3.3 cc , and 5.6 , respectively ) to long-term treatment ( 6.4 % , 2.0 cc , and 17.4 , respectively , P < 0.01 for all ) . Percent epithelial contraction was similar in the peripheral and transition zones ( P = NS ) . The transition zone remained a relatively constant proportion ( 53 % to 58 % ) of whole-prostate volume from baseline to long-term observation . CONCLUSIONS Long-term finasteride treatment ( 24 to 30 months ) results in a marked involution of the prostate epithelium , which continues to progress for many months after clinical effects stabilize . The effect on the epithelium is similar in the peripheral and transition zones for both morphometric and volumetric changes . Progressive contraction of the prostate epithelium appears to constitute the underlying mechanism for sustained action of finasteride PURPOSE Bleeding associated with transurethral prostate resection can often be significant and lead to increased morbidity and occasionally mortality . It has been shown that finasteride decreases bleeding in patients with hematuria of prostatic origin . We hypothesized that bleeding in patients undergoing transurethral prostate resection could be decreased by giving finasteride for 2 weeks before surgery . MATERIAL S AND METHODS A total 70 patients scheduled to undergo elective transurethral prostate resection were r and omized to receive 5 mg . finasteride daily or placebo for 2 weeks before surgery . Serum hemoglobin was measured before and after surgery , and the following day . The volume of irrigation fluid used and its hemoglobin concentration as well as resected prostate weight were recorded . RESULTS Of the 68 patients who underwent transurethral prostate resection 2 were withdrawn before surgery , and so 32 received finasteride and 36 received placebo . There was significantly less mean blood loss in irrigation fluid in the finasteride group than in the control group ( 43.6 versus 69.3 gm . hemoglobin , p = 0.011 ) . The mean difference was more significant when blood loss per gm . resected prostate was calculated ( 2.65 versus 4.65 gm . hemoglobin per gm . prostate , p < 0.01 ) . CONCLUSIONS This study shows that finasteride given for 2 weeks preoperatively decreases bleeding in patients undergoing transurethral prostate resection . Further study is required to determine the optimal timing and dose duration to minimize blood loss and identify how relevant such a decrease in bleeding is in clinical practice In the present study we aim ed to demonstrate the efficacy of short-term pretreatment with finasteride in patients undergoing transurethral resection of the prostate ( TUR-P ) . For this purpose 40 patients with BPH , who were c and i date s for TUR-P , were r and omized into two groups . The first group ( n=20 ) received 5 mg finasteride/day for 4 weeks prior to surgery and the second group ( n=20 ) remained as the control .  Patients who underwent prior prostate or urethral surgery and had a diagnosis of prostate cancer or chronic renal failure , patients who received finasteride , aspirin , coumadin or similar anticoagulant drugs prior to surgery and patients who had capsule perforations or open sinuses during the surgery were excluded from the study . All patients had a normal digital rectal examination and PSA values less than 4 ng/ml . As we look at the results there was no statistically significant difference between the finasteride group and control group regarding age , IPSS , PSA , prostate volumes , preoperative serum hemoglobin , hematocrit values and mean operating times and used irrigating fluids . The total amount of bleeding and bleeding per gram resected tissue were significantly lower in the finasteride group regardless of prostate volume . Furthermore the decrease in the hemoglobin and hematocrit values was higher in the control group . As a conclusion four weeks of finasteride pretreatment provided a significant decrease in peroperative bleeding regardless of prostate volume without any major side effects OBJECTIVE The pharmacological action of 5-alpha-reductase inhibitors ( 5-ARI ) would reduce angiogenesis associated with benign prostatic hyperplasia ( BPH ) , thereby decreasing peroperative bleeding during transurethral resection of the prostate ( TURP ) . Dutasteride , a double inhibitor of 5-alpha-reductase iso-enzymes types 1 and 2 , was not been previously studied in the context of reduction of peroperative bleeding related to TURP . MATERIAL AND METHODS We conducted a multicentre , r and omized , double-blind , placebo-controlled , parallel group study to evaluate the efficacy of dutasteride 0.5 mg per day , in peroperative bleeding related to TURP for BPH in patients over the age of 50 years with a prostatic volume greater than 30 cm3 . Treatment was administered for 4 weeks before the operation . The primary endpoint was haemoglobin , expressed in grams , and expressed in relation to the weight of prostate resected , also expressed in grams . RESULTS 59 patients were evaluated ( 32 treated with dutasteride and 27 treated with placebo ) . A significant difference in peroperative bleeding was observed between the dutasteride group ( 1.944 + /- 1.816 g of Hb/g of prostate resected ) and the placebo group ( 1.401 + /- 1.021 g of Hb/g of prostate resected ) . Preoperative treatment was well tolerated . CONCLUSION The working hypothesis of the study was not confirmed due to the low bleeding rate in the placebo group and the results suggest that a longer duration of treatment with dutasteride would reduce intraoperative and postoperative bleeding in TURP OBJECTIVES To study whether pretreatment with finasteride , compared with placebo , reduces the blood loss , operating time , amount of irrigating fluid absorbed , re sources used , and other exploratory indexes of extensive surgery during transurethral resection of the prostate ( TURP ) . METHODS This double-blind , r and omized , placebo-controlled , single-center , 6-month pilot study was design ed to study the effects of 3 months of finasteride ( 5 mg daily ) on blood loss during surgery in 60 men who required TURP . The prostate size was measured by transrectal ultrasonography , the surgical blood loss was measured by a HemoCue photometer , and fluid absorption was determined by the ethanol method . The microvessel density was counted using microscopic staining and immunoperoxidase techniques . RESULTS Finasteride significantly reduced the prostate size before TURP ( P < 0.001 versus placebo ) . No significant between-group differences were found in blood loss ( geometric mean 257 and 268 mL for finasteride versus placebo )  , fluid absorption , operating time , resection weight , or microvessel density . A positive correlation was found between the blood loss and the resection weight . Exploratory analyses indicated that finasteride might reduce the proportion of patients with high blood loss volumes . For prostates with resection weights greater than or equal to the median ( 18.6 g ) , finasteride was associated with less blood loss ( median 324 mL , n = 14 ) than in the controls ( median 547 mL , n = 14 , P < 0.01 ) . CONCLUSIONS Pretreatment with finasteride may help reduce the blood loss in TURP , except in the smallest resections Introduction : In the present study we evaluated the effect of short-term finasteride treatment on microvessel density (MVD)which is an indicator of prostatic angiogenesis in patients with hematuria secondary to benign prostatic hyperplasia ( BPH ) . Material s and Methods : 30 patients who were c and i date s for BPH surgery were prospect ively included in the study . All patients had history of gross hematuria and evaluated by ultrasonography and cystoscopy . The patients were r and omized two groups before surgery . The treatment group consisted of 13 patients who were given 5 mg finasteride daily for 4 weeks before surgery . The control group consisted of 17 patients who did not receive finasteride before surgery . During surgery , resected suburethral and hyperplastic prostate specimens were sent for histopathologic MVD determination separately . Results : Mean MVD in the suburethral portion of prostate was significantly lower in patients treated with finasteride when compared with controls ( 9.08 ± 5.6 and 13.94 ± 5.90 , respectively , p < 0.05 ) . Mean MVD for the hyperplastic portion of prostate was similar for the finasteride and control groups ( 14.21 ± 7.10 and 19.75 ± 9.73 , respectively , p > 0.05 ) . Conclusion : The potential role of finasteride on hematuria related to BPH may be the suppressive effect on MVDin the suburethral tissue of prostate OBJECTIVES To assess the effects of finasteride on angiogenetic and hypoxia markers in benign prostatic hyperplasia . METHODS A total of 178 patients aged 51 to 85 years ( mean 68.7 ) with benign prostatic hyperplasia and awaiting transurethral prostate resection were prospect ively r and omized into a group of patients receiving finasteride  ( group 1 ; 88 patients ) and a group of patients who received no medication until transurethral prostate resection  ( group 2 ; 90 patients ) . Tissue specimens were immunohistochemically stained with monoclonal antibodies against CD34 for microvessel density ( MVD ) , vascular endothelial growth factor ( VEGF ) , and hypoxia inducible factor-1alpha ( HIF-1alpha ) . RESULTS Blood loss during transurethral prostate resection was significantly higher in group 2 compared with group 1 ( P < 0.001 ) . The distribution of CD34 immunostaining was mainly at the suburethral prostate . MVD , VEGF , and HIF-1alpha values were significantly lower statistically ( P < 0.001 ) in group 1 compared with group 2 . In the finasteride group ( group 1 ) , the positive correlation of the immunoreactivity of CD34 and HIF-1alpha , VEGF and HIF-1alpha , and VEGF and CD34 was statistically significant ( P < 0.001 ) . In the same group , MVD and VEGF and HIF-1alpha expression correlated statistically with the treatment duration . CONCLUSIONS Finasteride administration in benign prostatic 
    Output:
    
We found that preoperative finasteride treatment decreases microvessel density ( MVD ) in resected prostate specimens .
Total blood loss , blood loss per gram of resected prostate tissue and decreases in haemoglobin were all greatly reduced in the finasteride group as compared to controls .
Dutasteride appeared to have no effect on bleeding .
This meta- analysis shows that preoperative finasteride treatment could decrease intraoperative haemorrhage during surgery for BPH .