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Minimally Invasive Treatments for Benign Prostatic Hyperplasia: Systematic Review and Network Meta-Analysis

原文:2022年 发布于 J Vasc Interv Radiol 33卷 第4期 359-367.e8 浏览量:1363次 原文链接

作者: Sajan A. Mehta T. Desai P. et al

作者单位: Department of Radiology, Columbia University Irving Medical Center, New York, New York. Electronic address: https://twitter.com/abinsm8. Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland. Vascular Interventional Partners - NOVA, Falls Church, Virginia. Prostate Centers USA, Raleigh, North Carolina. Vascular Interventional Partners - NOVA, Falls Church, Virginia. Electronic address: sbagla@prostatecentersusa.com.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1016/j.jvir.2021.12.029

关键词: Minimally Invasive Treatments Benign Prostatic Hyperplasia Systematic Review Network Meta-Analysis

文献简介

PURPOSE: To review and to compare indirectly the outcomes of minimally invasive therapies for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. MATERIALS AND METHODS: A literature search via Medline and Cochrane Central databases was completed for randomized control studies published between January 2000 to April 2020 for the following therapies: Rezum, Urolift, Aquablation, and prostatic artery embolization (PAE). Data on the following variables were included: International prostate symptom score (IPSS), maximum urinary flow rate, quality of life, and postvoid residual (PVR). Standard mean differences between treatments were compared through a meta-analysis using transurethral resection of the prostate (TURP) to assess differences in treatment effect. RESULTS: There was no significant difference in outcomes between therapies for IPSS at the 3, 6, and 12-month follow ups. Although outcomes for Rezum were only available out to 3 months, there were no consistently significant differences in outcomes when comparing Aquablation versus PAE versus Rezum. TURP PVR was significantly better than Urolift at 3, 6, and 12 months. No significant differences in minor or major adverse events were noted. CONCLUSION: Although significant differences in outcomes were limited, Aquablation and PAE were the most durable at 12 months. PAE has been well studied on multiple randomized control trials with minimal adverse events while Aquablation has limited high quality data and has been associated with bleeding-related complications.

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