Dean Elterman, Peter Gilling, Claus Roehrborn, Neil Barber, Vincent Misrai, Kevin C Zorn, Naeem Bhojani, Alexis Te, Mitch Humphreys, Steven Kaplan, Mihir Desai, Thorsten Bach
{"title":"对不同前列腺解剖结构的前列腺增生引起的下尿路症状行水溶消融术后功能结果的个体数据进行meta分析。","authors":"Dean Elterman, Peter Gilling, Claus Roehrborn, Neil Barber, Vincent Misrai, Kevin C Zorn, Naeem Bhojani, Alexis Te, Mitch Humphreys, Steven Kaplan, Mihir Desai, Thorsten Bach","doi":"10.1136/bmjsit-2021-000090","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate functional outcomes following Aquablation in various prostate volume and anatomical subgroups.</p><p><strong>Design: </strong>A meta-analysis with individual patient data undergoing Aquablation therapy from four prospective, global, clinical studies that have been conducted with Aquablation; WATER, WATER II, FRANCAIS WATER and OPEN WATER.</p><p><strong>Setting: </strong>Australia, Canada, Lebanon, Germany, New Zealand, UK and the USA.</p><p><strong>Participants: </strong>425 men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 1-year follow-up.</p><p><strong>Interventions: </strong>Aquablation therapy is an ultrasound guided, robotically executed waterjet ablative procedure for the prostate.</p><p><strong>Main outcome measures: </strong>The analyses focus International Prostate Symptom Score (IPSS), uroflowmetry, postoperative Incontinence Severity Index (ISI) and surgical retreatment.</p><p><strong>Results: </strong>425 men with prostates ranging in size from 20 to 150 mL underwent Aquablation therapy. The outcomes from the seven questions in the IPSS questionnaire were grouped by the following; prostates <100 mL, prostates ≥100 mL, prostate anatomy with an obstructive median lobe identifed by imaging, and prostate anatomy without an obstructive median lobe. Regardless of subgroup, all outcomes are consistent and demonstrate a significant improvement from baseline. Specifically, improvements in frequency, urgency and nocturia demonstrated bladder function improvement. Patients entering treatment with severe incontinence, ISI score >4, and regardless of prostate size, showed a reduction in incontinence during patient follow-up. Surgical retreatment due to BPH symptoms occurred in 0.7% (95% CI 0.1%-2.0%).</p><p><strong>Conclusions: </strong>Across a variety of prostate anatomies, Aquablation therapy showed remarkable functional improvements following the index procedure. Additionally, men with moderate to severe LUTS/BPH and overactive bladder resulting in urge incontinence showed a reduction in incontinence symptoms postprocedure.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"3 1","pages":"e000090"},"PeriodicalIF":2.1000,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjsit-2021-000090","citationCount":"7","resultStr":"{\"title\":\"Meta-analysis with individual data of functional outcomes following Aquablation for lower urinary tract symptoms due to BPH in various prostate anatomies.\",\"authors\":\"Dean Elterman, Peter Gilling, Claus Roehrborn, Neil Barber, Vincent Misrai, Kevin C Zorn, Naeem Bhojani, Alexis Te, Mitch Humphreys, Steven Kaplan, Mihir Desai, Thorsten Bach\",\"doi\":\"10.1136/bmjsit-2021-000090\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate functional outcomes following Aquablation in various prostate volume and anatomical subgroups.</p><p><strong>Design: </strong>A meta-analysis with individual patient data undergoing Aquablation therapy from four prospective, global, clinical studies that have been conducted with Aquablation; WATER, WATER II, FRANCAIS WATER and OPEN WATER.</p><p><strong>Setting: </strong>Australia, Canada, Lebanon, Germany, New Zealand, UK and the USA.</p><p><strong>Participants: </strong>425 men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 1-year follow-up.</p><p><strong>Interventions: </strong>Aquablation therapy is an ultrasound guided, robotically executed waterjet ablative procedure for the prostate.</p><p><strong>Main outcome measures: </strong>The analyses focus International Prostate Symptom Score (IPSS), uroflowmetry, postoperative Incontinence Severity Index (ISI) and surgical retreatment.</p><p><strong>Results: </strong>425 men with prostates ranging in size from 20 to 150 mL underwent Aquablation therapy. The outcomes from the seven questions in the IPSS questionnaire were grouped by the following; prostates <100 mL, prostates ≥100 mL, prostate anatomy with an obstructive median lobe identifed by imaging, and prostate anatomy without an obstructive median lobe. Regardless of subgroup, all outcomes are consistent and demonstrate a significant improvement from baseline. Specifically, improvements in frequency, urgency and nocturia demonstrated bladder function improvement. Patients entering treatment with severe incontinence, ISI score >4, and regardless of prostate size, showed a reduction in incontinence during patient follow-up. Surgical retreatment due to BPH symptoms occurred in 0.7% (95% CI 0.1%-2.0%).</p><p><strong>Conclusions: </strong>Across a variety of prostate anatomies, Aquablation therapy showed remarkable functional improvements following the index procedure. Additionally, men with moderate to severe LUTS/BPH and overactive bladder resulting in urge incontinence showed a reduction in incontinence symptoms postprocedure.</p>\",\"PeriodicalId\":33349,\"journal\":{\"name\":\"BMJ Surgery Interventions Health Technologies\",\"volume\":\"3 1\",\"pages\":\"e000090\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2021-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1136/bmjsit-2021-000090\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Surgery Interventions Health Technologies\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjsit-2021-000090\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Surgery Interventions Health Technologies","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjsit-2021-000090","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 7
摘要
目的:评价不同前列腺体积和解剖亚群水合消融术后的功能结局。设计:一项荟萃分析，对接受水消融治疗的个体患者数据进行荟萃分析，这些数据来自四项使用水消融进行的前瞻性、全球性临床研究;水，水2，法国的水和开放的水。地点:澳大利亚、加拿大、黎巴嫩、德国、新西兰、英国和美国。参与者:425名因良性前列腺增生(BPH)而出现下尿路症状(LUTS)的男性，随访1年。干预措施:水消融治疗是一种超声引导，机器人执行的前列腺水射流消融程序。主要观察指标:国际前列腺症状评分(IPSS)、尿流测量、术后尿失禁严重程度指数(ISI)和手术再治疗。结果:425名前列腺大小在20 - 150ml的男性接受了水消融治疗。IPSS问卷中七个问题的结果按以下方式分组;前列腺，无论前列腺大小，在患者随访期间显示尿失禁的减少。因BPH症状再次手术治疗的患者占0.7% (95% CI 0.1%-2.0%)。结论:在各种前列腺解剖结构中，水消融治疗在指数手术后显示出显着的功能改善。此外，中度至重度LUTS/BPH和膀胱过度活动导致急迫性尿失禁的男性术后尿失禁症状减少。
Meta-analysis with individual data of functional outcomes following Aquablation for lower urinary tract symptoms due to BPH in various prostate anatomies.
Objectives: To evaluate functional outcomes following Aquablation in various prostate volume and anatomical subgroups.
Design: A meta-analysis with individual patient data undergoing Aquablation therapy from four prospective, global, clinical studies that have been conducted with Aquablation; WATER, WATER II, FRANCAIS WATER and OPEN WATER.
Setting: Australia, Canada, Lebanon, Germany, New Zealand, UK and the USA.
Participants: 425 men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 1-year follow-up.
Interventions: Aquablation therapy is an ultrasound guided, robotically executed waterjet ablative procedure for the prostate.
Main outcome measures: The analyses focus International Prostate Symptom Score (IPSS), uroflowmetry, postoperative Incontinence Severity Index (ISI) and surgical retreatment.
Results: 425 men with prostates ranging in size from 20 to 150 mL underwent Aquablation therapy. The outcomes from the seven questions in the IPSS questionnaire were grouped by the following; prostates <100 mL, prostates ≥100 mL, prostate anatomy with an obstructive median lobe identifed by imaging, and prostate anatomy without an obstructive median lobe. Regardless of subgroup, all outcomes are consistent and demonstrate a significant improvement from baseline. Specifically, improvements in frequency, urgency and nocturia demonstrated bladder function improvement. Patients entering treatment with severe incontinence, ISI score >4, and regardless of prostate size, showed a reduction in incontinence during patient follow-up. Surgical retreatment due to BPH symptoms occurred in 0.7% (95% CI 0.1%-2.0%).
Conclusions: Across a variety of prostate anatomies, Aquablation therapy showed remarkable functional improvements following the index procedure. Additionally, men with moderate to severe LUTS/BPH and overactive bladder resulting in urge incontinence showed a reduction in incontinence symptoms postprocedure.
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