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Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis

PURPOSE: Thanks to advancements in surgical techniques and instruments, many surgical modalities have been developed to replace transurethral resection of the prostate (TURP). However, TURP remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH). We conducted a met...

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Autores principales: Lee, Seung Wook, Choi, Jong Bo, Lee, Kyu-Sung, Kim, Tae-Hyoung, Son, Hwancheol, Jung, Tae Young, Oh, Seung-June, Jeong, Hee Jong, Bae, Jae Hyun, Lee, Young-Suk, Kim, Joon Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Continence Society 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713243/
https://www.ncbi.nlm.nih.gov/pubmed/23869269
http://dx.doi.org/10.5213/inj.2013.17.2.59
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author Lee, Seung Wook
Choi, Jong Bo
Lee, Kyu-Sung
Kim, Tae-Hyoung
Son, Hwancheol
Jung, Tae Young
Oh, Seung-June
Jeong, Hee Jong
Bae, Jae Hyun
Lee, Young-Suk
Kim, Joon Chul
author_facet Lee, Seung Wook
Choi, Jong Bo
Lee, Kyu-Sung
Kim, Tae-Hyoung
Son, Hwancheol
Jung, Tae Young
Oh, Seung-June
Jeong, Hee Jong
Bae, Jae Hyun
Lee, Young-Suk
Kim, Joon Chul
author_sort Lee, Seung Wook
collection PubMed
description PURPOSE: Thanks to advancements in surgical techniques and instruments, many surgical modalities have been developed to replace transurethral resection of the prostate (TURP). However, TURP remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH). We conducted a meta-analysis on the efficacy and safety of minimally invasive surgical therapies for BPH compared with TURP. METHODS: This meta-analysis used a Medline search assessing the period from 1997 to 2011. A total of 784 randomized controlled trials were identified in an electronic search. Among the 784 articles, 36 randomized controlled trials that provided the highest level of evidence (level 1b) were included in the meta-analysis. We also conducted a quality analysis of selected articles. RESULTS: Only 2 articles (5.56%) were assessed as having a low risk of bias by use of the Cochrane collaboration risk of bias tool. On the other hand, by use of the Jadad scale, there were 26 high-quality articles (72.22%). Furthermore, 28 articles (77.78%) were assessed as high-quality articles by use of the van Tulder scale. Holmium laser enucleation of the prostate (HoLEP) showed the highest reduction of the International Prostate Symptom Score compared with TURP (P<0.0001). Bipolar TURP, bipolar transurethral vaporization of the prostate, HoLEP, and open prostatectomy showed superior outcome in postvoid residual urine volume and maximum flow rate. The intraoperative complications of the minimally invasive surgeries had no statistically significant inferior outcomes compared with TURP. Also, there were no statistically significant differences in any of the modalities compared with TURP. CONCLUSIONS: The selection of an appropriate surgical modality for BPH should be assessed by fully understanding each patient's clinical conditions.
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spelling pubmed-37132432013-07-18 Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis Lee, Seung Wook Choi, Jong Bo Lee, Kyu-Sung Kim, Tae-Hyoung Son, Hwancheol Jung, Tae Young Oh, Seung-June Jeong, Hee Jong Bae, Jae Hyun Lee, Young-Suk Kim, Joon Chul Int Neurourol J Original Article PURPOSE: Thanks to advancements in surgical techniques and instruments, many surgical modalities have been developed to replace transurethral resection of the prostate (TURP). However, TURP remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH). We conducted a meta-analysis on the efficacy and safety of minimally invasive surgical therapies for BPH compared with TURP. METHODS: This meta-analysis used a Medline search assessing the period from 1997 to 2011. A total of 784 randomized controlled trials were identified in an electronic search. Among the 784 articles, 36 randomized controlled trials that provided the highest level of evidence (level 1b) were included in the meta-analysis. We also conducted a quality analysis of selected articles. RESULTS: Only 2 articles (5.56%) were assessed as having a low risk of bias by use of the Cochrane collaboration risk of bias tool. On the other hand, by use of the Jadad scale, there were 26 high-quality articles (72.22%). Furthermore, 28 articles (77.78%) were assessed as high-quality articles by use of the van Tulder scale. Holmium laser enucleation of the prostate (HoLEP) showed the highest reduction of the International Prostate Symptom Score compared with TURP (P<0.0001). Bipolar TURP, bipolar transurethral vaporization of the prostate, HoLEP, and open prostatectomy showed superior outcome in postvoid residual urine volume and maximum flow rate. The intraoperative complications of the minimally invasive surgeries had no statistically significant inferior outcomes compared with TURP. Also, there were no statistically significant differences in any of the modalities compared with TURP. CONCLUSIONS: The selection of an appropriate surgical modality for BPH should be assessed by fully understanding each patient's clinical conditions. Korean Continence Society 2013-06 2013-06-30 /pmc/articles/PMC3713243/ /pubmed/23869269 http://dx.doi.org/10.5213/inj.2013.17.2.59 Text en Copyright © 2013 Korean Continence Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Seung Wook
Choi, Jong Bo
Lee, Kyu-Sung
Kim, Tae-Hyoung
Son, Hwancheol
Jung, Tae Young
Oh, Seung-June
Jeong, Hee Jong
Bae, Jae Hyun
Lee, Young-Suk
Kim, Joon Chul
Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title_full Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title_fullStr Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title_full_unstemmed Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title_short Transurethral Procedures for Lower Urinary Tract Symptoms Resulting From Benign Prostatic Enlargement: A Quality and Meta-Analysis
title_sort transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement: a quality and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713243/
https://www.ncbi.nlm.nih.gov/pubmed/23869269
http://dx.doi.org/10.5213/inj.2013.17.2.59
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