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Surgical Reintervention Rate after Prostatic Urethral Lift: Systematic Review and Meta-Analysis Involving over 2,000 Patients

原文:2020年 发布于 J Urol 204卷 第5期 1019-1026 浏览量:690次 原文链接

作者: Miller L. E. Chughtai B. Dornbier R. A. McVary K. T.

作者单位: Miller Scientific, Johnson City, Tennessee. Department of Urology, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York. Center for Male Health, Department of Urology, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1097/ju.0000000000001132

关键词: Device Removal/statistics & numerical data Humans Male Minimally Invasive Surgical Procedures/*adverse effects/instrumentation Prostatic Hyperplasia/complications/surgery Prostatism/etiology *Prosthesis Failure Randomized Controlled Trials as Topic Reoperation/*statistics & numerical data Transurethral Resection of Prostate/statistics & numerical data Treatment Outcome meta-analysis prostatic hyperplasia urologic surgical procedures

文献简介

PURPOSE: The surgical reintervention rate after prostatic urethral lift is not well characterized but has been estimated at 2% to 3% per year. We performed a systematic review and meta-analysis to determine the surgical reintervention rate after prostatic urethral lift. MATERIALS AND METHODS: We systematically searched MEDLINE®, Embase® and the Cochrane Central Register of Controlled Trials for studies of men treated with prostatic urethral lift reporting at least 1 year of maximum followup data. We performed a random effects meta-analysis to estimate the annual rate of surgical reintervention after prostatic urethral lift, including those performed for lower urinary tract symptoms or involving device explant, additions or replacement. The robustness of the meta-analysis conclusions was evaluated in a one-study removed analysis and heterogeneity was investigated with a subgroup analysis. RESULTS: In 11 studies (2,016 patients) 153 surgical reinterventions were performed, among which transurethral resection of the prostate/laser (51.0%), repeat prostatic urethral lift (32.7%) and device explant (19.6%) were most common. The annual rate of surgical reintervention was 6.0% per year (95% CI 3.0-8.9). These results were not significantly influenced by any single study. The annual rate of surgical intervention was significantly influenced by the mean duration of patient followup. Surgical reintervention rates were 4.3% per year in studies with 1 year or less mean followup, 10.7% per year in studies with more than 1 year to 3 years mean followup and 5.8% per year in a single study with more than 3 years mean followup (p=0.04). CONCLUSIONS: The surgical reintervention rate with prostatic urethral lift is 6.0% per year and is higher in studies with longer followup durations.

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