首页良性前列腺增生治疗及预后证据详情

Comparison on the Efficacy and Safety of Different Surgical Treatments for Benign Prostatic Hyperplasia With Volume >60 mL: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

原文:2021年 发布于 Am J Mens Health 15卷 第6期 浏览量:1708次 原文链接

作者: Wang Y. B. Yan S. Y. Xu X. F. Huang X. Luo L. S. Deng Y. Q. Li X. H. Huang Q. Wang Y. Y. Huang J. Jin Y. H. Zeng X. T.

作者单位: Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China. Department of Urology, Xianyang Central Hospital, Xianyang, China. Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China. Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, China.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1177/15579883211067086

关键词: Humans Male Network Meta-Analysis *Prostatic Hyperplasia/surgery Quality of Life Randomized Controlled Trials as Topic *Transurethral Resection of Prostate Treatment Outcome *benign prostatic hyperplasia *network meta-analysis *prostate volume *surgical treatment conflicts of interest with respect to the research authorship and/or publication of this article.

文献简介

The objective of this study was to compare the efficacy and safety of 10 different surgical treatments for benign prostatic hyperplasia (BPH) with volume >60 mL. A systematic literature review and network meta-analysis of randomized controlled trials (RCTs) within a Bayesian framework was performed. A total of 52 parallel-group RCTs included, reporting on 6,947 participants, comparing open prostatectomy (OP), monopolar/bipolar transurethral resection of prostate (monopolar/ bipolar TURP), thulium, holmium and diode laser enucleation of prostate (LEP), bipolar enucleation of prostate, potassium titanyl phosphate laser vaporization of prostate (KTP LVP), bipolar vaporization of prostate (bipolar VP), and laparoscopic simple prostatectomy (laparoscope SP). Compared with OP, laparoscope SP identified better maximal flow rate (Qmax; mean differences [MDs] = 2.89 mL/s) at the 24th month, but bipolar VP demonstrated worse Qmax (MD = -3.20 mL/s) and International Prostate Symptom Score (IPSS; MD = 2.60) at the 12th month. Holmium LEP (MD = 1.37) demonstrated better International Index of Erectile Function-5 at the 12th month compared with OP. However, compared with OP, KTP LVP demonstrated worse postvoid residual volume (PVR) at the sixth (MD = 10.42 mL) and 12th month (MD = 5.89 mL) and monopolar TURP (MD = 6.9 mL) demonstrated worse PVR at the 12th month. Eight new surgical methods for BPH with volume >60 mL appeared to be superior in safety compared with OP and monopolar TURP due to fewer complications. Bipolar VP and KTP LVP maybe not suitable for prostates more than 60 mL due to short- and middle-term worse Qmax, IPSS, and PVR than OP.

热门文献