Andrea Alberti, Francesca Conte, Sara Costagli, Anna Cadenar, Rossella Nicoletti, Alessio Pecoraro, Arcangelo Sebastianelli, Jeremy Yuen Chun Teoh, Antonio Cicione, Riccardo Autorino, Henry H Woo, Ruben De Groote, Dean Elterman, Marcus Drake, Stavros Gravas, Vincenzo Ficarra, Cosimo De Nunzio, Sergio Serni, Riccardo Campi, Mauro Gacci
{"title":"内镜下摘除与机器人辅助简单前列腺切除术治疗大前列腺：对患者观点的系统回顾和荟萃分析。","authors":"Andrea Alberti, Francesca Conte, Sara Costagli, Anna Cadenar, Rossella Nicoletti, Alessio Pecoraro, Arcangelo Sebastianelli, Jeremy Yuen Chun Teoh, Antonio Cicione, Riccardo Autorino, Henry H Woo, Ruben De Groote, Dean Elterman, Marcus Drake, Stavros Gravas, Vincenzo Ficarra, Cosimo De Nunzio, Sergio Serni, Riccardo Campi, Mauro Gacci","doi":"10.1038/s41391-025-00973-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Since Endoscopic Enucleation of the Prostate [EEP] and Robot-Assisted Simple Prostatectomy [RASP] showed comparable functional results, treatment selection is often based on clinicians' and patients' preferences. The aim of this systematic review was to compare Patient-Reported Outcomes Measures [PROMs] and Patient-Reported Experience Measures [PREMs] in patients with large prostate glands treated with EEP and RASP.</p><p><strong>Evidence acquisition: </strong>Literature search was performed on August 29<sup>th</sup> 2024 using the MEDLINE, EMBASE, and Cochrane CENTRAL databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All comparative studies reporting validated PROMs/PREMs for both interventions (EEP and RASP) were included. Studies reporting within-treatment comparisons only (e.g., HoLEP vs. ThuLEP) were excluded.</p><p><strong>Evidence synthesis: </strong>Ten studies involving 1105 patients (430 RASP, 675 EEP) were included in this systematic review. Follow-up ranged from 2 to 24 months. Considering urinary function, all authors reported a great improvement for both EEP and RASP at short- and mid-term, with no significant differences between endoscopic and robotic procedures. Alongside the lower symptom scores, patient-reported Quality of Life [QoL] significantly improved for both techniques. Erectile function remained stable after EEP and RASP in most of the studies, while some of them even reported a significant improvement. No studies reporting PREMs were retrieved.</p><p><strong>Conclusions: </strong>Both RASP and EEP led to a great improvement in urinary function and QoL, safeguarding sexual function, with no significant difference between the different techniques in terms of functional outcomes. None of the included studies reported PREMs. A standardization of PROMs/PREMs and their integration in clinical practice is warranted, to understand the real impact of these treatments, helping physicians and patients for an individualized shared decision-making process.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscopic enucleation vs. robot-assisted simple prostatectomy for large prostates: a systematic review and meta-analysis of patients' perspectives.\",\"authors\":\"Andrea Alberti, Francesca Conte, Sara Costagli, Anna Cadenar, Rossella Nicoletti, Alessio Pecoraro, Arcangelo Sebastianelli, Jeremy Yuen Chun Teoh, Antonio Cicione, Riccardo Autorino, Henry H Woo, Ruben De Groote, Dean Elterman, Marcus Drake, Stavros Gravas, Vincenzo Ficarra, Cosimo De Nunzio, Sergio Serni, Riccardo Campi, Mauro Gacci\",\"doi\":\"10.1038/s41391-025-00973-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Since Endoscopic Enucleation of the Prostate [EEP] and Robot-Assisted Simple Prostatectomy [RASP] showed comparable functional results, treatment selection is often based on clinicians' and patients' preferences. The aim of this systematic review was to compare Patient-Reported Outcomes Measures [PROMs] and Patient-Reported Experience Measures [PREMs] in patients with large prostate glands treated with EEP and RASP.</p><p><strong>Evidence acquisition: </strong>Literature search was performed on August 29<sup>th</sup> 2024 using the MEDLINE, EMBASE, and Cochrane CENTRAL databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All comparative studies reporting validated PROMs/PREMs for both interventions (EEP and RASP) were included. Studies reporting within-treatment comparisons only (e.g., HoLEP vs. ThuLEP) were excluded.</p><p><strong>Evidence synthesis: </strong>Ten studies involving 1105 patients (430 RASP, 675 EEP) were included in this systematic review. Follow-up ranged from 2 to 24 months. Considering urinary function, all authors reported a great improvement for both EEP and RASP at short- and mid-term, with no significant differences between endoscopic and robotic procedures. Alongside the lower symptom scores, patient-reported Quality of Life [QoL] significantly improved for both techniques. Erectile function remained stable after EEP and RASP in most of the studies, while some of them even reported a significant improvement. No studies reporting PREMs were retrieved.</p><p><strong>Conclusions: </strong>Both RASP and EEP led to a great improvement in urinary function and QoL, safeguarding sexual function, with no significant difference between the different techniques in terms of functional outcomes. None of the included studies reported PREMs. A standardization of PROMs/PREMs and their integration in clinical practice is warranted, to understand the real impact of these treatments, helping physicians and patients for an individualized shared decision-making process.</p>\",\"PeriodicalId\":20727,\"journal\":{\"name\":\"Prostate Cancer and Prostatic Diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.8000,\"publicationDate\":\"2025-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Prostate Cancer and Prostatic Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41391-025-00973-w\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prostate Cancer and Prostatic Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41391-025-00973-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Endoscopic enucleation vs. robot-assisted simple prostatectomy for large prostates: a systematic review and meta-analysis of patients' perspectives.
Introduction: Since Endoscopic Enucleation of the Prostate [EEP] and Robot-Assisted Simple Prostatectomy [RASP] showed comparable functional results, treatment selection is often based on clinicians' and patients' preferences. The aim of this systematic review was to compare Patient-Reported Outcomes Measures [PROMs] and Patient-Reported Experience Measures [PREMs] in patients with large prostate glands treated with EEP and RASP.
Evidence acquisition: Literature search was performed on August 29th 2024 using the MEDLINE, EMBASE, and Cochrane CENTRAL databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All comparative studies reporting validated PROMs/PREMs for both interventions (EEP and RASP) were included. Studies reporting within-treatment comparisons only (e.g., HoLEP vs. ThuLEP) were excluded.
Evidence synthesis: Ten studies involving 1105 patients (430 RASP, 675 EEP) were included in this systematic review. Follow-up ranged from 2 to 24 months. Considering urinary function, all authors reported a great improvement for both EEP and RASP at short- and mid-term, with no significant differences between endoscopic and robotic procedures. Alongside the lower symptom scores, patient-reported Quality of Life [QoL] significantly improved for both techniques. Erectile function remained stable after EEP and RASP in most of the studies, while some of them even reported a significant improvement. No studies reporting PREMs were retrieved.
Conclusions: Both RASP and EEP led to a great improvement in urinary function and QoL, safeguarding sexual function, with no significant difference between the different techniques in terms of functional outcomes. None of the included studies reported PREMs. A standardization of PROMs/PREMs and their integration in clinical practice is warranted, to understand the real impact of these treatments, helping physicians and patients for an individualized shared decision-making process.
期刊介绍：
Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management.
Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis.
Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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