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01-09-2021 | Benign Prostatic Hypertrophy | Original Article

Effectiveness of convective water vapor energy therapy versus prostatic urethral lift for symptomatic benign prostatic hyperplasia: a systematic review and indirect comparison

Authors: Christopher T. Tallman, Paul F. Zantek, Natalia Hernandez, Ronald A. Morton Jr., Dongfeng Qi, Ricardo R. Gonzalez

Published in: World Journal of Urology | Issue 9/2021

Abstract

Purpose

To synthesize the evidence from randomized controlled trials of prostatic urethral lift (PUL) and convective water vapor thermal energy therapy (WAVE) for minimally invasive treatment of men with benign prostatic hyperplasia.

Methods

A systematic search of databases was performed to identify trials comparing WAVE or PUL to either an active or sham surgery control in subjects with symptomatic benign prostatic obstruction. A controlled indirect treatment comparison based on the approach of Bucher was performed for outcomes including International Prostate Symptom Score and maximum urinary flow rate (Qmax). The durability of treatment response was assessed by life-table analysis of freedom from retreatment through 4 years.

Results

Two multicenter sham-controlled trials (Rezum II Study, NCT01912339: LIFT Study, NCT01294150) were identified. The trials employed a common sham procedure and were similar with respect to their designs and subjects’ baseline characteristics. Comparisons on the treatment effect in excess of sham response found non-significant differences between WAVE and PUL for symptom score [mean difference (MD): − 1.7 points; 95% confidence interval (CI): − 4.8, 1.4] but Qmax improvements favored WAVE [MD: 3.4 ml/sec; CI: 1.2, 5.6]. The proportion free of retreatment through 4 years was 89.1% for WAVE versus 75.4% for PUL [log-rank P = 0.004].

Conclusions

PUL and WAVE provide similar subjective improvements but flow-rate improvement and durability of response seem greater for WAVE. The confirmation of these findings in a randomized trial is warranted.

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Title: Effectiveness of convective water vapor energy therapy versus prostatic urethral lift for symptomatic benign prostatic hyperplasia: a systematic review and indirect comparison
Authors: Christopher T. Tallman
Paul F. Zantek
Natalia Hernandez
Ronald A. Morton Jr.
Dongfeng Qi
Ricardo R. Gonzalez
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Benign Prostatic Hypertrophy
Benign Prostatic Hypertrophy
Thermal Therapy
Published in: World Journal of Urology / Issue 9/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03595-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of convective water vapor energy therapy versus prostatic urethral lift for symptomatic benign prostatic hyperplasia: a systematic review and indirect comparison

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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