首页良性前列腺增生治疗及预后证据详情

Symptomatic Improvement of Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A Comparative Systematic Review and Meta-Analysis of 4 Different Minimally Invasive Therapies

原文:2021年 发布于 J Vasc Interv Radiol 32卷 第9期 1328-1340.e11 浏览量:1038次 原文链接

作者: LaRussa S. Pantuck M. Wilcox Vanden Berg R. Gaffney C. D. Askin G. McClure T.

作者单位: Department of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian, New York, New York Department of Radiology, Einstein-Jacobi Medical Center, Bronx, New York. Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania. Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York. Division of Biostatistics, Department of Population Health Sciences, and Weill Cornell Medicine, New York, New York. Department of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian, New York, New York Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York. Electronic address: Tim9047@med.cornell.edu.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1016/j.jvir.2021.06.019

关键词: *Embolization Therapeutic Humans *Lower Urinary Tract Symptoms/etiology/therapy Male *Prostatic Hyperplasia/complications/therapy Quality of Life Treatment Outcome

文献简介

PURPOSE: To review and compare the outcomes of prostatic artery embolization (PAE) with 3 other minimally invasive surgical treatments for benign prostatic hyperplasia, including photoselective vaporization (PVP), prostatic urethral lift (PUL), and water vapor thermal therapy (WV). METHODS: A literature review was used to identify 35 publications, which included 2,653 patients (studies, patients): PVP (13, 949), PUL (9, 577), WV (3, 330), and PAE (10, 728). The international prostate symptom score (IPSS) and the international index of erectile function (IIEF-5) and quality of life (QOL) scores were recorded at baseline, 6 months, and 12 months. Meta-analyses, pooling the standardized mean difference between scores recorded before and after treatment, were conducted for each modality and time point to assess the magnitude of a therapy's effect to yield pooled effect sizes. A negative score indicates IPSS and QOL improvement. A positive score indicates IIEF-5 improvement. RESULTS: At 6 and 12 months, the IPSS and QOL were most improved after PVP, followed by that after PAE, PUL, and, lastly, WV (measured only at 12 months). Between 6 and 12 months, the IPSS and QOL improved with PAE and worsened with PVP and PUL. Only PAE demonstrated statistical improvement in the IIEF-5, which improved from 6 to 12 months. CONCLUSIONS: PVP and PAE resulted in the largest improvements in the IPSS and QOL. Only PAE resulted in improvement of the IIEF-5.

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