Tratamiento quirúrgico de la hiperplasia prostática benigna: Revisión de la literatura
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i5.490Palabras clave:
Hiperplasia prostática, procedimientos quirúrgicos, operativo, resultados del tratamiento, síntomas del tracto urinario inferiorResumen
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.
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