Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia

Background: Minimally invasive simple prostatectomy (MISP) and endoscopic enucleation of the prostate (EEP) are the two most commonly used methods for large benign prostatic hyperplasia (BPH), but it remains unclear which of the two is superior. This study aims to perform a pooled analysis to compar...

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Autores principales:	Jinze Li, Dehong Cao, Chunyang Meng, Zhongyou Xia, Lei Peng, Yunxiang Li, Qiang Wei
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	minimally invasive simple prostatectomy endoscopic enucleation benign prostatic hyperplasia outcomes meta-analysis Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/1ad1913d3bd7455dbe6e28df5b8386ab
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spelling	oai:doaj.org-article:1ad1913d3bd7455dbe6e28df5b8386ab2021-11-05T10:05:40ZComparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia2296-858X10.3389/fmed.2021.773257https://doaj.org/article/1ad1913d3bd7455dbe6e28df5b8386ab2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.773257/fullhttps://doaj.org/toc/2296-858XBackground: Minimally invasive simple prostatectomy (MISP) and endoscopic enucleation of the prostate (EEP) are the two most commonly used methods for large benign prostatic hyperplasia (BPH), but it remains unclear which of the two is superior. This study aims to perform a pooled analysis to compare efficacy and safety profiles between MISP and EEP.Methods: We conducted a comprehensive search of PubMed, Embase, Web of Science, and ClinicalTrials.gov databases to identify eligible studies comparing MISP with EEP. Parameters including efficacy and safety outcomes were compared using Stata 14.0 version.Results: Eight comparative trials with 1,504 patients were included. Compared to MISP, EEP demonstrated shorter operative time (mean difference [MD] 46.37, 95% confidence interval [CI] 19.92 to 72.82, p = 0.0006), lesser hemoglobin decrease (standardized MD [SMD] 0.59, 95% CI 0.23 to 0.95, p = 0.001), lower catheterization time (SMD 4.13, 95% CI 2.16 to 6.10, p < 0.001), and shorter length of stay (SMD 2.38, 95% CI 1.40 to 3.36, p < 0.001). However, overall complications and blood transfusions did not differ between the two groups. Moreover, EEP had better postvoid residual volume (PVR) at 6-month (MD 14.39, 95% CI 11.06 to 17.72, p < 0.001) and comparable 3- and 6-month International Prostate Symptom Score, 3- and 6-month maximum flow rate, 3-month PVR, and 3-month quality of life compared with MISP.Conclusion: Both MISP and EEP are effective and safe surgical procedures for the treatment of large BPH. EEP appears to have a superior perioperative profile compared to MISP. This should be interpreted with caution due to the significant heterogeneity between studies. Hence, treatment selection should be based on the surgeon's experience and availability.Jinze LiJinze LiDehong CaoChunyang MengZhongyou XiaZhongyou XiaLei PengYunxiang LiQiang WeiFrontiers Media S.A.articleminimally invasive simple prostatectomyendoscopic enucleationbenign prostatic hyperplasiaoutcomesmeta-analysisMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	minimally invasive simple prostatectomy endoscopic enucleation benign prostatic hyperplasia outcomes meta-analysis Medicine (General) R5-920
spellingShingle	minimally invasive simple prostatectomy endoscopic enucleation benign prostatic hyperplasia outcomes meta-analysis Medicine (General) R5-920 Jinze Li Jinze Li Dehong Cao Chunyang Meng Zhongyou Xia Zhongyou Xia Lei Peng Yunxiang Li Qiang Wei Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
description	Background: Minimally invasive simple prostatectomy (MISP) and endoscopic enucleation of the prostate (EEP) are the two most commonly used methods for large benign prostatic hyperplasia (BPH), but it remains unclear which of the two is superior. This study aims to perform a pooled analysis to compare efficacy and safety profiles between MISP and EEP.Methods: We conducted a comprehensive search of PubMed, Embase, Web of Science, and ClinicalTrials.gov databases to identify eligible studies comparing MISP with EEP. Parameters including efficacy and safety outcomes were compared using Stata 14.0 version.Results: Eight comparative trials with 1,504 patients were included. Compared to MISP, EEP demonstrated shorter operative time (mean difference [MD] 46.37, 95% confidence interval [CI] 19.92 to 72.82, p = 0.0006), lesser hemoglobin decrease (standardized MD [SMD] 0.59, 95% CI 0.23 to 0.95, p = 0.001), lower catheterization time (SMD 4.13, 95% CI 2.16 to 6.10, p < 0.001), and shorter length of stay (SMD 2.38, 95% CI 1.40 to 3.36, p < 0.001). However, overall complications and blood transfusions did not differ between the two groups. Moreover, EEP had better postvoid residual volume (PVR) at 6-month (MD 14.39, 95% CI 11.06 to 17.72, p < 0.001) and comparable 3- and 6-month International Prostate Symptom Score, 3- and 6-month maximum flow rate, 3-month PVR, and 3-month quality of life compared with MISP.Conclusion: Both MISP and EEP are effective and safe surgical procedures for the treatment of large BPH. EEP appears to have a superior perioperative profile compared to MISP. This should be interpreted with caution due to the significant heterogeneity between studies. Hence, treatment selection should be based on the surgeon's experience and availability.
format	article
author	Jinze Li Jinze Li Dehong Cao Chunyang Meng Zhongyou Xia Zhongyou Xia Lei Peng Yunxiang Li Qiang Wei
author_facet	Jinze Li Jinze Li Dehong Cao Chunyang Meng Zhongyou Xia Zhongyou Xia Lei Peng Yunxiang Li Qiang Wei
author_sort	Jinze Li
title	Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
title_short	Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
title_full	Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
title_fullStr	Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
title_full_unstemmed	Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia
title_sort	comparison of the efficacy and safety of minimally invasive simple prostatectomy and endoscopic enucleation of prostate for large benign prostatic hyperplasia
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1ad1913d3bd7455dbe6e28df5b8386ab
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Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia

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