Andry Irawan, Ignatius Riwanto, Eriawan Agung Nugroho


Objective: This study proves differentiation of the combination of dutasteride and green tea, dutasteride, green tea, and placebo alone and their association with differences in hematocrit levels and the expression of hypoxia induced factor-1 alpha (HIF-1α) in patients with Benign Prostate Hyperplasia (BPH) were performed Trans urethral resection of the prostate (TURP) surgery. Material & method: Experimental study with the draft "randomized control trial". Comparing angiogenesis changes between groups of BPH patients who underwent TURP surgery to assess the expression of HIF-1α and Δ Ht (Hematocrit) after administration of dutasteride, green tea with combination of dutasteride and green tea for 14 days. Results: The combination of dutasteride and green tea was not significant in reducing the expression of HIF-1α. Mean P1 group (59.32 ± 14.69); P2 group (59.11 ± 20.73); P3 group (64.21 ± 14.95); K group (58.16 ± 16.00). Kruskal test results obtained p=0.491 walis which means the difference percentage of HIF-1α among the 4 groups was not significant. The mean Δ Ht P1 group (0.61 ± 0.204); P2 group (0.54 ± 0.250); P3 group (0.41 ± 0.275); group K (0.41 ± 0.275). In statistical test with Mann Whitney test comparing the percentage reduction obtained Ht levels dutasteride group against group of green tea obtained p=0.213 means that there is no significant difference. Where a significant difference to the other groups. Conclusion: The combination of dutasteride and green tea for 14 days before TURP surgery does not reduce the expression of HIF-1α in BPH patients who underwent TURP surgery. Δ Ht significant decline in the combination group compared with other groups and might be influenced by several factors during TURP surgery.


HIF-1α; hematocrit; benign prostate hyperplasia; dutasteride; green tea

Full Text:



Fawzy A, Pool LJ. Benign prostate hyperthrophy and the role of alpha adrenergic blockade. Release date: Sept 30, 2003. In http:///

Mc Connel JD, Roehrborn CG. Etiology, pathophysiology, and natural history of benign prostatic hyperplasia. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein A eds. Campbell’s Urology, 8th Ed. Philadelphia: WB Saunders; 2002. p. 1297–330.

Yuwana R. Permasalahan Bedah Urologi pada Manula. Semarang: UPG Ilmu Bedah FK UNDIP.

Rachmat BP, Soetojo. Perbedaan kadar PSA dan TGF β-1 terhadap pemberian kombinasi 5α reduktase inhibitor (dutasteride) dan anti estrogen (tamoxifen) pada penderita BPH-LUTS. FK UNAIR Surabaya; 2006.

Tohir GA. Prostatektomi transvesikal: Faktor yang berperan terhadap perdarahan. 1992 Bagian bedah FK Undip/RSDK Semarang.

Haryanto AS. Perbandingan perdarahan pada operasi TVP antara teknik penjahitan leher buli konvensional dan dobel semi sirkuler. Karya Akhir Penelitian. Bagian Bedah FK Undip/RSDK Semarang.

Robert G Hahn, Fagerstrom T, Tammela TL, Van Vierssen TO, Beisland HO, Duggan A, et al. Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride. BJU Int. 2007; 99: 587–94.

Shanmugasundaram R, Singh JC, Kekre NS. Does dutasteride reduce perioperative blood loss and postoperative complications after transurethral resection of the prostate? Uroscan. 2007; 23(3): 334–5.

Walsh PC, Retik AB. Transurethral surgery. In: Campbell’s Urology 7th Ed. Philadelphia: WB Saunders; 1998. p. 1511–28.

Foley CL, Bott SR, Kirby RS. An update on the 5 alpha reductase inhibitor. Timely Top Med Urol. June 2003; 4.

Chapple CR. Pharmacological therapy of benign prostatic/lower urinary tract symptoms: An overview for the practicing clinician. BJU Int. 2004; 94: 738–44.

Ku JH, Shin JK, Cho MC, Myung JK, Moon KC, Paick JS. Effect of dutasteride on the expression of hypoxia-inducible factor-1alpha, vascular endothelial growth factor and microvessel density in rat and human prostate tissue. Scand J Urol Nephrol. 2009; 43(6): 445–53.

Nickel JC. Comparisson of clinical trial with finasteride and dutasteride. Rev Urol. 2004; 6(supp 9): S31–S39.

Fassina G, Vene R, Morini M, Minghelli S, Benelli R, Noonan DM, et al. Mechanism of inhibition of tumor angiogenesis and vascular tumor growth by epigallocatechin 3 gallate. Clin Cancer Res. July 2004; 10: 4865–73.

Thomas R, Kim MH, Epigallocatechin gallate inhibits HIF-1 alpha degradation in prostate cancer cells. Biochem Biophys Res Commun. Aug 2005; 334(2): 543–8.

Detchokul S, Frauman AG. Recent development in prostate cancer biomarker research: Therapeutic implications. Br J Clin Pharmacol. 2011; 71(2): 157–74.

Mabjesh N. Willard, Frederickson, Zhong CE, Simons JW. Androgen stimulate hypoxia–inducible factor 1 activation via autocrine loop of tyrosine kinase receptor/phospatidylinositol 3’–kinase/protein kinase B in prostate cancer cells. Clin Cancer Res. 2003; 9: 2416.

Hilpakka RA, Zang HZ, Dai W, Dai Q, Liao S. Tructure–activity relationships for inhibition of human 5 alpha–reductase by polyphenols. Biochem Pharmacol. Mar 2002; 63(6): 1165–76.

Liao S, Hiipakka RS. Selective inhibition of steroid 5 alpha – reductase isoenzymes by tea epicatechin–3–gallate and epigallocatechin–3–gallate. Biochem Biophys Res Commun. Sep 1995; 214(3): 833–8.

Kravchick S, Peled R, Cytron S. Effect of short term dutasteride therapy on prostate vascularity in patients with BPH: A pilot study. EAU; 2007.

Pastore AL, Palleschi G, Mariani S, Barrese F, Valentini MA, Cappa M, et al. Transurethral resection of prostate and the role of pharmacological treatment with dutasteride in decreasing surgical blood loss. J Endourol. Jan 2013; 27(1): 68–70. doi: 10.1089/end.2012.0231. Epub 2012 Oct 3.

Higdon JV, Frei B. Tea catechins and polyphenols: Health effects, metabolism, and antioxidant functions. Critical Reviews in Food Science and Nutrition; 2003.

Chow HHS, Hakim IA, Vining DR, Crowel JA, Ranger-Moore J, Chew VM, et al. Effects of dosing condition on the oral bioavailibility of green tea catechins after single dose administration of polyphenon E in healthy individuals. Clin Cancer Res. June 2005; 11(12): 4627–33.

Matsumura A, Kubota T, Taiyoh H, Fujiwara H, Okamoto K, Ichikawa D, et al. HGF regulates VEGF expression via the c-Met receptor downstream pathways, PI3K/Akt, MAPK and STAT3, in CT26 murine cells. Int J Oncol. 2013; 42: 535–42.

Ather MH, Faruqui N, Abid F. Optimization of low pre–operative hemoglobin reduces transfusion requirement in patients undergoing transurethral resection of prostate. JPMA. 2003; 53: 104.

Kirollos MM, Campbell N. Factors influencing blood loss in transurethral resection of the prostate (TURP): Auditing TURP. Br J Viol. 1997; 80: III–IS.

Miyao H, Kotake Y, Kakoi H, Sekiguchi H, Kawazoe T. TURP syndrome and changes in body fluid distribution. J Saitama Med School. 2001; 28: 1–8.

Hahn RG, Fagerstrom T, Tammela TL, Van Vierssen Trip O, Beisland HO, Duggan A, et al. Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride. BJU Int. Mar 2007; 99(3): 587–94.

Boccon–Gibod L, Valton M, Ibrahim H, Comenducci A. Effect of dutasteride on reduction of intraoperative bleeding related to transurethral resection of prostate. Prog Urol. Dec 2005; 15(6): 1085–9.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.