Tratamiento quirúrgico de la hiperplasia prostática benigna: Revisión de la literatura

  • Hugo López-Ramos Pontificia Universidad Javeriana, Bogotá, Colombia https://orcid.org/0000-0002-5895-3029
  • John Alexander Bolívar-Barragán Pontificia Universidad Javeriana, Bogotá, Colombia https://orcid.org/0000-0001-5685-8354
  • Sara de Vivero Pontificia Universidad Javeriana, Bogotá, Colombia https://orcid.org/0000-0003-4787-1228
  • Sebastián Bojanini Pontificia Universidad Javeriana, Bogotá, Colombia
  • María Cecilia De La Espriella Pontificia Universidad Javeriana, Bogotá, Colombia
Palabras clave: Hiperplasia prostática, procedimientos quirúrgicos, operativo, resultados del tratamiento, síntomas del tracto urinario inferior

Resumen

Introducción: La hiperplasia prostática benigna HPB es una patología prevalente. Dependiendo de la severidad del tracto urinario bajo se define la necesidad del manejo médico o quirúrgico, el cual tiene como patrón de oro, la resección transuretral de la próstata por sistema bipolar  TURP-B Objetivo: Determinar el estado actual de las diferentes técnicas quirúrgicas  para comparar su eficacia y seguridad en el tratamiento de hiperplasia prostática benigna.

Métodos. Se realizó una busqueda en cinco bases de datos PUBMED, Embase, Lilacs, Science Direct y Greynet. Se evaluaron metaanálisis, revisiones sistemáticas y ensayos clínicos aleatorizados determinando la eficacia y seguridad de las técnicas quirúrgicas para el tratamiento de HPB entre los años 2006 al año 2016.

Resultados: A partir de 2505 artículos escogidos por título y resumen, 94 artículos fueron escogidos para revisión del texto completo. Se encontraron diferentes técnicas quirúrgicas; TURP por método monopolar o bipolar, prostatectomía abierta, vaporización del plasma, técnicas laser, técnicas ablativas mínimamente invasivas. La mayoría de los artículos compara TURP-B (patrón de oro) vs otros métodos quirúrgicos; enfocándose en desenlaces clínicos basados en escalas de IPSS score, Qmax, PVR y QoL;  Observándose resultados similares entre todas las técnicas.

Conclusiones: TURP-B es la técnica más practicada para el manejo de HPB, con buenos resultados en comparación con TURP-M. Resultados similares entre TURP-B con HoLEP, ThuLEP, Greenlight láser, TUMT. La decisión de la técnica quirúrgica sera elegida según la experticia del cirujano y las caracteristicas de cada paciente. Los resultados aquí presentados son heterogéneos y hacen necesario mayor investigación. 

Citas

Mobley D, Feibus A, Baum N. Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment. Postgraduate Medicine. 2015 May 4;127(3):301–7. doi: https://doi.org/10.1080/00325481.2015.1018799

Cornu J-N, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, et al. A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update. Eur Urol. 2015 Jun;67(6):1066–96. doi: https://doi.org/10.1016/j.eururo.2014.06.017

Ben-Zvi T, Hueber P-A, Abdollah F, Liberman D, Bhojani N, Gautam G, et al. Short term outcomes of GreenLight vapor incision technique (VIT) of the prostate: comparison of outcomes to standard GreenLight 120W HPS vaporization in prostate volumes greater than 80 cc. Can J Urol. 2013 Feb;20(1):6633–9.

Netsch C, Knoll T, Gross AJ, Wendt-Nordahl G. [Thulium vapoenucleation of prostates larger than 80 ml using a 1.9-µm and a 2-µm thulium laser. Early perioperative results from two centres]. Urologe A. 2015 Oct;54(10):1414–20. doi: https://doi.org/10.1007/s00120-014-3652-8

Arai Y, Aoki Y, Okubo K, Maeda H, Terada N, Matsuta Y, et al. Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function: a prospective study. J Urol. 2000 Oct;164(4):1206–11.

Shih H-J, Chow Y-C, Huang C-J, Su Y-H, Lin W-C, Yang S. Catheter-assisted transurethral resection of the prostate: a novel approach. Urologia internationalis. 2008;80(4):383–8. doi: https://doi.org/10.1159/000132696

Hoekstra RJ, Melick HHEV, Kok ET, Bosch JLHR. A 10-year follow-up after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia; long-term results of a randomized controlled trial. British Journal of Urology International. 2010 Sep;106(6):822–6. doi: https://doi.org/10.1111/j.1464-410X.2010.09229.x

Fagerström T, Nyman CR, Hahn RG. Complications and clinical outcome 18 months after bipolar and monopolar transurethral resection of the prostate. J Endourol. 2011 Jun;25(6):1043–9. doi: https://doi.org/10.1089/end.2010.0714

Stucki P, Marini L, Mattei A, Xafis K, Boldini M, Danuser H. Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. J Urol. 2015 Apr;193(4):1371–5. doi: https://doi.org/10.1016/j.juro.2014.08.137

Komura K, Inamoto T, Takai T, Uchimoto T, Saito K, Tanda N, et al. Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: results from a randomised trial. BJU Int. 2015 Apr;115(4):644–52. doi: https://doi.org/10.1111/bju.12831

Chen Q, Zhang L, Liu YJ, Lu JD, Wang GM. Bipolar transurethral resection in saline system versus traditional monopolar resection system in treating large-volume benign prostatic hyperplasia. Urol Int. 2009;83(1):55–9. doi: https://doi.org/10.1159/000224869

Mamoulakis C, Skolarikos A, Schulze M, Scoffone CM, Rassweiler JJ, Alivizatos G, et al. Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. BJU Int. 2012 Jan;109(2):240–8. doi: https://doi.org/10.1111/j.1464-410X.2011.10222.x

Yee C, Wong JH, Chiu PK, Chan C, Lee W, Tsu JH, et al. Short-stay transurethral prostate surgery: A randomized controlled trial comparing transurethral resection in saline bipolar transurethral vaporization of the prostate with monopolar transurethral resection. Asian J Endosc Surg. 2015 Aug;8(3):316–22. doi: https://doi.org/10.1111/ases.12197

Tefekli A, Muslumanoglu AY, Baykal M, Binbay M, Tas A, Altunrende F. A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. J Urol. 2005 Oct;174(4 Pt 1):1339–43. doi: https://doi.org/10.1097/01.ju.0000173075.62504.73

Hu Y, Dong X, Wang G, Huang J, Liu M, Peng B. Five-Year Follow-Up Study of Transurethral Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia. J Endourol. 2016 Jan;30(1):97–101. doi: https://doi.org/10.1089/end.2015.0506

Gupta NP, Anand A. Comparison of TURP, TUVRP, and HoLEP. Curr Urol Rep. 2009 Jul;10(4):276–8.

Liao N, Yu J. Transurethral bipolar plasmakinetic resection combined with 2 μm continuous wave laser vaporization: a new method for the treatment of large volume benign prostatic hyperplasia. Photomed Laser Surg. 2012 Jun;30(6):320–4. doi: https://doi.org/10.1089/pho.2011.3181

Xie J, Tan Y, Wang F, Xuan Q, Sun Y, Xiao J, et al. Extraperitoneal laparoscopic adenomectomy (Madigan) versus bipolar transurethral resection of the prostate for benign prostatic hyperplasia greater than 80 ml: complications and functional outcomes after 3-year follow-up. J Endourol. 2014 Mar;28(3):353–9. doi: https://doi.org/10.1089/end.2013.0374

Geavlete B, Moldoveanu C, Iacoboaie C, Geavlete P. Bipolar plasma vaporization versus standard transurethral resection in secondary bladder neck sclerosis: a prospective, medium-term, randomized comparison. Ther Adv Urol. 2013 Apr;5(2):75–83. doi: https://dx.doi.org/10.1177%2F1756287212470695

Liu C-K, Lee W-K, Ko M-C, Chiang H-S, Wan K-S. Transurethral electrovapor resection versus standard transurethral resection treatment for a large prostate: a 2-year follow-up study conducted in Taiwan. Urol Int. 2006;76(2):144–9. doi: https://doi.org/10.1159/000090878

Nuhoğlu B, Ayyildiz A, Karagüzel E, Cebeci O, Germiyanoğlu C. Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: results of 1-year follow up. Int J Urol. 2006 Jan;13(1):21–4. doi: https://doi.org/10.1111/j.1442-2042.2006.01218.x

Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, et al. A Multicenter Randomized Noninferiority Trial Comparing GreenLight-XPS Laser Vaporization of the Prostate and Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Obstruction: Two-yr Outcomes of the GOLIATH Study. Eur Urol. 2016 Jan;69(1):94–102. doi: https://doi.org/10.1016/j.eururo.2015.07.054

Bachmann A, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, et al. A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-month results of the GOLIATH study. J Urol. 2015 Feb;193(2):570–8. doi: https://doi.org/10.1016/j.juro.2014.09.001

Elshal AM, Elkoushy MA, El-Nahas AR, Shoma AM, Nabeeh A, Carrier S, et al. GreenLightTM laser (XPS) photoselective vapo-enucleation versus holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic hyperplasia: a randomized controlled study. J Urol. 2015 Mar;193(3):927–34. doi: https://doi.org/10.1016/j.juro.2014.09.097

Telli O, Okutucu TM, Suer E, Burgu B, Gulpinar O, Yaman O, et al. A prospective, randomized comparative study of monopolar transurethral resection of the prostate versus photoselective vaporization of the prostate with GreenLight 120-W laser, in prostates less than 80 cc. Ther Adv Urol. 2015 Feb;7(1):3–8. doi: https://doi.org/10.1177/1756287214556643

Lukacs B, Loeffler J, Bruyère F, Blanchet P, Gelet A, Coloby P, et al. Photoselective vaporization of the prostate with GreenLight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol. 2012 Jun;61(6):1165–73. doi: https://doi.org/10.1016/j.eururo.2012.01.052

Capitán C, Blázquez C, Martin MD, Hernández V, de la Peña E, Llorente C. GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up. Eur Urol. 2011 Oct;60(4):734–9. doi: https://doi.org/10.1016/j.eururo.2011.05.043

Pereira-Correia JA, de Moraes Sousa KD, Santos JBP, de Morais Perpétuo D, Lopes-da-Silva LF, Krambeck RL, et al. GreenLight HPSTM 120-W laser vaporization vs transurethral resection of the prostate (<60 mL): a 2-year randomized double-blind prospective urodynamic investigation. BJU Int. 2012 Oct;110(8):1184–9. doi: https://doi.org/10.1111/j.1464-410X.2011.10878.x

Skolarikos A, Papachristou C, Athanasiadis G, Chalikopoulos D, Deliveliotis C, Alivizatos G. Eighteen-month results of a randomized prospective study comparing transurethral photoselective vaporization with transvesical open enucleation for prostatic adenomas greater than 80 cc. J Endourol. 2008 Oct;22(10):2333–40. doi: https://doi.org/10.1089/end.2008.9709

Jovanović M, Džamić Z, Aćimović M, Kajmaković B, Pejčić T. Usage of GreenLight HPS 180-W laser vaporisation for treatment of benign prostatic hyperplasia. Acta Chir Iugosl. 2014;61(1):57–61.

Horasanli K, Silay MS, Altay B, Tanriverdi O, Sarica K, Miroglu C. Photoselective Potassium Titanyl Phosphate (KTP) Laser Vaporization Versus Transurethral Resection of the Prostate for Prostates Larger Than 70 mL: A Short-Term Prospective Randomized Trial. Urology. 2008 Feb 1;71(2):247–51. doi: https://doi.org/10.1016/j.urology.2007.09.017

Bouchier-Hayes DM, Van Appledorn S, Bugeja P, Crowe H, Challacombe B, Costello AJ. A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. BJU Int. 2010 Apr;105(7):964–9. doi: https://doi.org/10.1111/j.1464-410X.2009.08961.x

Wu G, Hong Z, Li C, Bian C, Huang S, Wu D. A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up. Lasers Med Sci. 2016 May;31(4):599–604. doi: https://doi.org/10.1007/s10103-016-1883-1

Chiang PH, Chen CH, Kang CH, Chuang YC. GreenLight HPS laser 120-W versus diode laser 200-W vaporization of the prostate: comparative clinical experience. Lasers Surg Med. 2010 Sep;42(7):624–9. doi: https://doi.org/10.1002/lsm.20940

Zhang B, Wu G, Chen C, Song B, Li X, Zhong L, et al. Combination of channel-TURP and ILC versus standard TURP or ILC for elderly with benign prostatic hyperplasia: a randomized prospective trial. Urol Int. 2011;87(4):392–9. doi: https://doi.org/10.1159/000331500

Razzaghi MR, Mazloomfard MM, Mokhtarpour H, Moeini A. Diode laser (980 nm) vaporization in comparison with transurethral resection of the prostate for benign prostatic hyperplasia: randomized clinical trial with 2-year follow-up. Urology. 2014 Sep;84(3):526–32. doi: https://doi.org/10.1016/j.urology.2014.05.027

Rigatti L, Naspro R, Salonia A, Centemero A, Ghezzi M, Guazzoni G, et al. Urodynamics after TURP and HoLEP in urodynamically obstructed patients: are there any differences at 1 year of follow-up? Urology. 2006 Jun;67(6):1193–8. doi: https://doi.org/10.1016/j.urology.2005.12.036

Basić D, Stanković J, Potić M, Ignjatović I, Stojković I. Holmium laser enucleation versus transurethral resection of the prostate: a comparison of clinical results. Acta Chir Iugosl. 2013;60(1):15–20.

Fayad AS, Elsheikh MG, Zakaria T, Elfottoh HA, Alsergany R, Elshenoufy A, et al. Holmium Laser Enucleation of the Prostate Versus Bipolar Resection of the Prostate: A Prospective Randomized Study. ‘Pros and Cons’. Urology. 2015 Nov;86(5):1037–41. doi: https://doi.org/10.1016/j.urology.2015.08.004

Wilson LC, Gilling PJ, Williams A, Kennett KM, Frampton CM, Westenberg AM, et al. A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur Urol. 2006 Sep;50(3):569–73. doi: https://doi.org/10.1016/j.eururo.2006.04.002

Elmansy HM, Elzayat E, Elhilali MM. Holmium laser ablation versus photoselective vaporization of prostate less than 60 cc: long-term results of a randomized trial. J Urol. 2010 Nov;184(5):2023–8. doi: https://doi.org/10.1016/j.juro.2010.06.107

Sun N, Fu Y, Tian T, Gao J, Wang Y, Wang S, et al. Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a randomized clinical trial. Int Urol Nephrol. 2014 Jul;46(7):1277–82. doi: https://doi.org/10.1007/s11255-014-0646-9

Ahyai SA, Lehrich K, Kuntz RM. Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol. 2007 Nov;52(5):1456–63. doi: https://doi.org/10.1016/j.eururo.2007.04.053

Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int. 2012 Feb;109(3):408–11. doi: https://doi.org/10.1111/j.1464-410X.2011.10359.x

Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol. 2008 Jan;53(1):160–6. doi: https://doi.org/10.1016/j.eururo.2007.08.036

Wei H, Shao Y, Sun F, Sun X, Zhuo J, Zhao F, et al. Thulium laser resection versus plasmakinetic resection of prostates larger than 80 ml. World J Urol. 2014 Aug;32(4):1077–85. doi: https://doi.org/10.1007/s00345-013-1210-4

Cui D, Sun F, Zhuo J, Sun X, Han B, Zhao F, et al. A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results. World J Urol. 2014 Jun;32(3):683–9. doi: https://doi.org/10.1007/s00345-013-1103-6

Yan H, Ou T-W, Chen L, Wang Q, Lan F, Shen P, et al. Thulium laser vaporesection versus standard transurethral resection of the prostate: a randomized trial with transpulmonary thermodilution hemodynamic monitoring. Int J Urol. 2013 May;20(5):507–12. doi: https://doi.org/10.1111/j.1442-2042.2012.03183.x

Zhu Z, Shen Z, Tu F, Zhu Y, Sun F, Shao Y, et al. Thulium laser vaporesection versus transurethral electrovaporization of the prostate in high-risk patients with benign prostatic hyperplasia. Photomed Laser Surg. 2012 Dec;30(12):714–8. doi: https://doi.org/10.1089/pho.2012.3316

Luo Y-H, Shen J-H, Guan R-Y, Li H, Wang J. Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urology. 2014 Oct;84(4):904–10. doi: https://doi.org/10.1016/j.urology.2014.06.025

Chen S, Zhu L, Cai J, Zheng Z, Ge R, Wu M, et al. Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: a randomized noninferiority controlled trial with long-term results at 6 years. Eur Urol. 2014 Aug;66(2):284–91. doi: https://doi.org/10.1016/j.eururo.2014.01.010

Zhao Z, Zeng G, Zhong W, Mai Z, Zeng S, Tao X. A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol. 2010 Nov;58(5):752–8. doi: https://doi.org/10.1016/j.eururo.2010.08.026

Zhu L, Chen S, Yang S, Wu M, Ge R, Wu W, et al. Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup. J Urol. 2013 Apr;189(4):1427–31. doi: https://doi.org/10.1016/j.juro.2012.10.117

Mattiasson A, Wagrell L, Schelin S, Nordling J, Richthoff J, Magnusson B, et al. Five-year follow-up of feedback microwave thermotherapy versus TURP for clinical BPH: a prospective randomized multicenter study. Urology. 2007 Jan;69(1):91–6; discussion 96-97. doi: https://doi.org/10.1016/j.urology.2006.08.1115

Schelin S, Geertsen U, Walter S, Spångberg A, Duelund-Jacobsen J, Krøyer K, et al. Feedback microwave thermotherapy versus TURP/prostate enucleation surgery in patients with benign prostatic hyperplasia and persistent urinary retention: a prospective, randomized, controlled, multicenter study. Urology. 2006 Oct;68(4):795–9. doi: https://doi.org/10.1016/j.urology.2006.05.020

Shore ND, Sethi PS. A controlled, randomized, head-to-head comparison of the Prolieve thermodilatation System versus the Targis System for benign prostatic hyperplasia: safety, procedural tolerability, and clinical results. J Endourol. 2010 Sep;24(9):1469–75. doi: https://doi.org/10.1089/end.2009.0416

Cantwell AL, Bogache WK, Richardson SF, Tutrone RF, Barkin J, Fagelson JE, et al. Multicentre prospective crossover study of the ‘prostatic urethral lift’ for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. BJU Int. 2014 Apr;113(4):615–22. doi: https://doi.org/10.1111/bju.12540

McVary KT, Gange SN, Shore ND, Bolton DM, Cowan BE, Brown BT, et al. Treatment of LUTS secondary to BPH while preserving sexual function: randomized controlled study of prostatic urethral lift. J Sex Med. 2014 Jan;11(1):279–87. doi: https://doi.org/10.1111/jsm.12333

Simforoosh N, Abdi H, Kashi AH, Zare S, Tabibi A, Danesh A, et al. Open prostatectomy versus transurethral resection of the prostate, where are we standing in the new era? A randomized controlled trial. Urol J. 2010;7(4):262–9.

Ou R, You M, Tang P, Chen H, Deng X, Xie K. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology. 2010 Oct;76(4):958–61. doi: https://doi.org/10.1016/j.urology.2010.01.079

Geavlete B, Bulai C, Ene C, Checherita I, Geavlete P. Bipolar vaporization, resection, and enucleation versus open prostatectomy: optimal treatment alternatives in large prostate cases? J Endourol. 2015 Mar;29(3):323–31. doi: https://doi.org/10.1089/end.2014.0493

Aoun F, Marcelis Q, Roumeguère T. Minimally invasive devices for treating lower urinary tract symptoms in benign prostate hyperplasia: technology update. Res Rep Urol. 2015;7:125–36. doi: https://doi.org/10.2147/RRU.S55340

Publicado
2019-11-15
Sección
Artículos de revisión