Transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement: A quality and meta-analysis

Seung Wook Lee, Jong Bo Choi, Kyu Sung Lee, Tae Hyoung Kim, Hwancheol Son, Tae Young Jung, Seung June Oh, Hee Jong Jeong, Jae Hyun Bae, Young Suk Lee, Joon Chul Kim

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Thanks to advancements in surgical techniques and instruments, many surgical modalities have been developed to replace transurethral resection of the prostate (TURP). However, TURP remains the gold standard for the surgical treatment of benign prostatic hyperplasia (BPH). We conducted a meta-analysis on the efficacy and safety of minimally invasive surgical therapies for BPH compared with TURP. Methods: This meta-analysis used a Medline search assessing the period from 1997 to 2011. A total of 784 randomized controlled trials were identified in an electronic search. Among the 784 articles, 36 randomized controlled trials that provided the highest level of evidence (level 1b) were included in the meta-analysis. We also conducted a quality analysis of selected articles. Results: Only 2 articles (5.56%) were assessed as having a low risk of bias by use of the Cochrane collaboration risk of bias tool. On the other hand, by use of the Jadad scale, there were 26 high-quality articles (72.22%). Furthermore, 28 articles (77.78%) were assessed as high-quality articles by use of the van Tulder scale. Holmium laser enucleation of the prostate (HoLEP) showed the highest reduction of the International Prostate Symptom Score compared with TURP (P<0.0001). Bipolar TURP, bipolar transurethral vaporization of the prostate, HoLEP, and open prostatectomy showed superior outcome in postvoid residual urine volume and maximum flow rate. The intraoperative complications of the minimally invasive surgeries had no statistically significant inferior outcomes compared with TURP. Also, there were no statistically significant differences in any of the modalities compared with TURP. Conclusions: The selection of an appropriate surgical modality for BPH should be assessed by fully understanding each patient's clinical conditions.

Original languageEnglish
Pages (from-to)59-66
Number of pages8
JournalInternational Neurourology Journal
Volume17
Issue number2
DOIs
Publication statusPublished - 2013

Keywords

  • Holmium
  • Lasers
  • Meta-analysis
  • Potassium titanylphosphate
  • Prostatic hyperplasia
  • Transurethral resection of prostate

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Urology

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  • Cite this

    Lee, S. W., Choi, J. B., Lee, K. S., Kim, T. H., Son, H., Jung, T. Y., Oh, S. J., Jeong, H. J., Bae, J. H., Lee, Y. S., & Kim, J. C. (2013). Transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement: A quality and meta-analysis. International Neurourology Journal, 17(2), 59-66. https://doi.org/10.5213/inj.2013.17.2.59