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Open Access 01-12-2024 | Benign Prostatic Hypertrophy | Systematic review update

Transurethral surgical treatment for benign prostatic hyperplasia with detrusor underactivity: a systematic review and meta-analysis

Authors: Peilin Zou, Chang Liu, Yucong Zhang, Chao Wei, Xiaming Liu, Shengfei Xu, Qing Ling, Zhong Chen, Guanghui Du, Xiaoyi Yuan

Published in: Systematic Reviews | Issue 1/2024

Abstract

Background

The efficacy of surgical treatment for benign prostatic hyperplasia (BPH) patients with detrusor underactivity (DU) remains controversial.

Methods

To summarize relevant evidence, three databases (PubMed, Embase, and Web of Science) were searched from database inception to May 1, 2023. Transurethral surgical treatment modalities include transurethral prostatectomy (TURP), photoselective vaporization of the prostate (PVP), and transurethral incision of the prostate (TUIP). The efficacy of the transurethral surgical treatment was assessed according to maximal flow rate on uroflowmetry (Q_max), International Prostate Symptom Score (IPSS), postvoid residual (PVR), quality of life (QoL), voided volume, bladder contractility index (BCI) and maximal detrusor pressure at maximal flow rate (PdetQ_max). Pooled mean differences (MDs) were used as summary statistics for comparison. The quality of enrolled studies was evaluated by using the Newcastle–Ottawa Scale. Sensitivity analysis and funnel plots were applied to assess possible biases.

Results

In this study, 10 studies with a total of 1142 patients enrolled. In BPH patients with DU, within half a year, significant improvements in Q_max (pooled MD, 4.79; 95% CI, 2.43–7.16; P < 0.05), IPSS(pooled MD, − 14.29; 95%CI, − 16.67–11.90; P < 0.05), QoL (pooled MD, − 1.57; 95% CI, − 2.37–0.78; P < 0.05), voided volume (pooled MD, 62.19; 95% CI, 17.91–106.48; P < 0.05), BCI (pooled MD, 23.59; 95% CI, 8.15–39.04; P < 0.05), and PdetQ_max (pooled MD, 28.62; 95% CI, 6.72–50.52; P < 0.05) were observed after surgery. In addition, after more than 1 year, significant improvements were observed in Q_max (pooled MD, 6.75; 95%CI, 4.35–9.15; P < 0.05), IPSS(pooled MD, − 13.76; 95%CI, − 15.17–12.35; P < 0.05), PVR (pooled MD, − 179.78; 95%CI, − 185.12–174.44; P < 0.05), QoL (pooled MD, − 2.61; 95%CI, − 3.12–2.09; P < 0.05), and PdetQ_max (pooled MD, 27.94; 95%CI, 11.70–44.19; P < 0.05). Compared with DU patients who did not receive surgery, DU patients who received surgery showed better improvement in PVR (pooled MD, 137.00; 95%CI, 6.90–267.10; P < 0.05) and PdetQ_max (pooled MD, − 8.00; 95%CI, − 14.68–1.32; P < 0.05).

Conclusions

Our meta-analysis results showed that transurethral surgery can improve the symptoms of BPH patients with DU. Surgery also showed advantages over pharmacological treatment for BPH patients with DU.

Systematic review registration

PROSPERO CRD42023415188.

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Title: Transurethral surgical treatment for benign prostatic hyperplasia with detrusor underactivity: a systematic review and meta-analysis
Authors: Peilin Zou
Chang Liu
Yucong Zhang
Chao Wei
Xiaming Liu
Shengfei Xu
Qing Ling
Zhong Chen
Guanghui Du
Xiaoyi Yuan
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Benign Prostatic Hypertrophy
Benign Prostatic Hypertrophy
Transurethral Prostate Resection
Published in: Systematic Reviews / Issue 1/2024
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-024-02514-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transurethral surgical treatment for benign prostatic hyperplasia with detrusor underactivity: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Systematic review registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Systematic review registration

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