Joao G Porto, Ansh M Bhatia, Abhishek Bhat, Maria Camila Suarez Arbelaez, Ruben Blachman-Braun, Khushi Shah, Ankur Malpani, Diana Lopategui, Thomas R W Herrmann, Robert Marcovich, Hemendra N Shah
{"title":"二十年来经尿道前列腺切除术的评估：随机临床试验的系统回顾和荟萃分析。","authors":"Joao G Porto, Ansh M Bhatia, Abhishek Bhat, Maria Camila Suarez Arbelaez, Ruben Blachman-Braun, Khushi Shah, Ankur Malpani, Diana Lopategui, Thomas R W Herrmann, Robert Marcovich, Hemendra N Shah","doi":"10.1007/s00345-024-05332-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022. We assessed International Prostate Symptom Score (IPSS), Peak Flow (Qmax), Post-void residue of urine (PVR), and post-operative complications. Heterogeneity was ranked as low (I<sup>2</sup> < 25%), moderate (I<sup>2</sup> = 25-75%), or high (I<sup>2</sup> > 75%).</p><p><strong>Results: </strong>TURP significantly improved IPSS, Qmax, and PVR, with the most recent studies showing superior results in IPSS and Qmax after 3 years compared to 2000-2004 studies. Heterogeneity in PVR was high (I<sup>2</sup> = 100%). No negative impact on erectile function was observed. Complication rates included TURP syndrome (2%), bleeding (8%), and blood transfusion (6%), but elevated heterogeneity with difference between the groups was seen in clot evacuation (I<sup>2</sup> = 83%) and urinary tract infections (I<sup>2</sup> = 82%). Other complications were urinary retention (4%), incontinence (8%), urethral stricture (3%), bladder neck stenosis (2%).</p><p><strong>Conclusion: </strong>In the last 20 years there has not been a clear trend in the results of TURP. The found heterogeneity may indicate a lack of standardization in TURP procedures. However, symptomatic improvement among patients is uniform, which supports this procedure as a historical benchmark surgical treatment for BPH.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"639"},"PeriodicalIF":2.8000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568034/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluating transurethral resection of the prostate over twenty years: a systematic review and meta-analysis of randomized clinical trials.\",\"authors\":\"Joao G Porto, Ansh M Bhatia, Abhishek Bhat, Maria Camila Suarez Arbelaez, Ruben Blachman-Braun, Khushi Shah, Ankur Malpani, Diana Lopategui, Thomas R W Herrmann, Robert Marcovich, Hemendra N Shah\",\"doi\":\"10.1007/s00345-024-05332-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022. We assessed International Prostate Symptom Score (IPSS), Peak Flow (Qmax), Post-void residue of urine (PVR), and post-operative complications. Heterogeneity was ranked as low (I<sup>2</sup> < 25%), moderate (I<sup>2</sup> = 25-75%), or high (I<sup>2</sup> > 75%).</p><p><strong>Results: </strong>TURP significantly improved IPSS, Qmax, and PVR, with the most recent studies showing superior results in IPSS and Qmax after 3 years compared to 2000-2004 studies. Heterogeneity in PVR was high (I<sup>2</sup> = 100%). No negative impact on erectile function was observed. Complication rates included TURP syndrome (2%), bleeding (8%), and blood transfusion (6%), but elevated heterogeneity with difference between the groups was seen in clot evacuation (I<sup>2</sup> = 83%) and urinary tract infections (I<sup>2</sup> = 82%). Other complications were urinary retention (4%), incontinence (8%), urethral stricture (3%), bladder neck stenosis (2%).</p><p><strong>Conclusion: </strong>In the last 20 years there has not been a clear trend in the results of TURP. The found heterogeneity may indicate a lack of standardization in TURP procedures. However, symptomatic improvement among patients is uniform, which supports this procedure as a historical benchmark surgical treatment for BPH.</p>\",\"PeriodicalId\":23954,\"journal\":{\"name\":\"World Journal of Urology\",\"volume\":\"42 1\",\"pages\":\"639\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568034/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00345-024-05332-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00345-024-05332-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Evaluating transurethral resection of the prostate over twenty years: a systematic review and meta-analysis of randomized clinical trials.
Purpose: The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.
Methods: We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022. We assessed International Prostate Symptom Score (IPSS), Peak Flow (Qmax), Post-void residue of urine (PVR), and post-operative complications. Heterogeneity was ranked as low (I2 < 25%), moderate (I2 = 25-75%), or high (I2 > 75%).
Results: TURP significantly improved IPSS, Qmax, and PVR, with the most recent studies showing superior results in IPSS and Qmax after 3 years compared to 2000-2004 studies. Heterogeneity in PVR was high (I2 = 100%). No negative impact on erectile function was observed. Complication rates included TURP syndrome (2%), bleeding (8%), and blood transfusion (6%), but elevated heterogeneity with difference between the groups was seen in clot evacuation (I2 = 83%) and urinary tract infections (I2 = 82%). Other complications were urinary retention (4%), incontinence (8%), urethral stricture (3%), bladder neck stenosis (2%).
Conclusion: In the last 20 years there has not been a clear trend in the results of TURP. The found heterogeneity may indicate a lack of standardization in TURP procedures. However, symptomatic improvement among patients is uniform, which supports this procedure as a historical benchmark surgical treatment for BPH.
期刊介绍：
The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
