首页良性前列腺增生治疗及预后证据详情

Systematic Review and Meta-analysis Comparing Prostatic Artery Embolization to Gold-Standard Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

原文:2021年 发布于 Cardiovasc Intervent Radiol 44卷 第2期 183-193 浏览量:643次 原文链接

作者: Knight G. M. Talwar A. Salem R. Mouli S.

作者单位: Department of Radiology, Section of Interventional Radiology, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA. Department of Radiology, Section of Interventional Radiology, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA. r-salem@northwestern.edu. Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago, IL, USA. r-salem@northwestern.edu. Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago, IL, USA.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1007/s00270-020-02657-5

关键词: Aged Arteries Embolization Therapeutic Humans Male Prostate/*blood supply/surgery Prostatic Hyperplasia/surgery/*therapy Reference Standards Transurethral Resection of Prostate Treatment Outcome

文献简介

PURPOSE: To report a comparative systematic review and meta-analysis of prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP) for the management of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A multi-database search for relevant literature was conducted on 15 July 2020 to include studies published on or before that date. Search terms used were: (prostate embolization OR prostatic embolization OR prostate embolization OR prostatic embolization) AND (prostatic hyperplasia OR prostatic obstruction). Risk of bias was assessed using Cochrane Collaboration and ROBINS-I criteria. Random-effects meta-analysis was performed using RevMan 5.3. RESULTS: Six studies with 598 patients were included. TURP was associated with significantly more improvement in maximum urinary flow rate (Q(max)) (mean difference = 5.02 mL/s; 95% CI [2.66,7.38]; p < 0.0001; I(2) = 89%), prostate volume (mean difference = 15.59 mL; 95% CI [7.93,23.25]; p < 0.00001; I(2) = 88%), and prostate-specific antigen (PSA) (mean difference = 1.02 ng/mL; 95% CI [0.14,1.89]; p = 0.02; I(2) = 71%) compared to PAE. No significant difference between PAE and TURP was observed for changes in International Prostate Symptoms Score (IPSS), IPSS quality of life (IPSS-QoL), International Index of Erectile Function (IIEF-5), and post-void residual (PVR). PAE was associated with fewer adverse events (AEs) (39.0% vs. 77.7%; p < 0.00001) and shorter hospitalization times (mean difference = -1.94 days; p < 0.00001), but longer procedural times (mean difference = 51.43 min; p = 0.004). CONCLUSION: Subjective symptom improvement was equivalent between TURP and PAE. While TURP demonstrated larger improvements for some objective parameters, PAE was associated with fewer AEs and shorter hospitalization times. LEVEL OF EVIDENCE II: Level 2a, Systematic Review.

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