Safety and efficacy of palliative transurethral resection of the prostate for lower urinary tract obstruction in patients with metastatic prostate cancer: a meta-analysis.

Abstract

Purpose: This meta-analysis aims to assess the safety, efficacy, and outcomes of palliative transurethral resection of the prostate (TURP) for relieving urinary obstruction in patients with metastatic prostate cancer.

Methods: A comprehensive literature search was performed across PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar to identify studies published before August 2024. The included studies reported pre- and post-treatment outcomes in patients undergoing palliative TURP for urinary obstruction. Data were analyzed using Comprehensive Meta-Analysis and Review Manager software. Study quality was evaluated using the Newcastle Ottawa Scale, and bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.

Results: Eight studies, including 3,080 patients with advanced prostate cancer, were included. Palliative TURP significantly reduced postvoid residual urine volume by a mean difference of 50.41 milliliters (95% confidence interval: 39.49-61.34, p < 0.00001) and improved the symptom score by 14.13 points (95% confidence interval: 10.03-18.23, p < 0.00001). However, no significant change was observed in the urinary flow rate (mean difference: 4.31 milliliters per second, p = 0.23). Reported complications included repeat TURP (23.4%), incontinence (13.9%), catheterization (10.8%), and TURP syndrome (2.7%).

Conclusion: Palliative TURP effectively improves urinary symptoms and reduces urinary retention in patients with metastatic prostate cancer. While it offers symptomatic relief, the risk of postoperative complications should be carefully considered in treatment planning.