Surgical treatment of benign prostatic hyperplasia: A literature review
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i5.490Keywords:
prostatic hyperplasia, surgical procedures, operative, treatment outcome, lower urinary tract symptomsAbstract
Introduction: Benign prostatic hyperplasia BPH is a prevalent pathology. Depending on the severity of the symptoms of the lower urinary tract, the need for medical or surgical management, which has as a gold standard, transurethral resection of the prostate by bipolar system TURP-B is defined. Aim: : To determine the current state of the different surgical techniques to compare its efficacy and safety in the treatment of benign prostatic hyperplasia.
Methods: A search was performed in five databases PUBMED, Embase, Lilacs, Science Direct and Greynet. Meta-analyzes, systematic reviews and randomized clinical trials were evaluated, determining the efficacy and safety of surgical techniques for the treatment of BPH between 2006 and 2016.
Results: From 2505 articles chosen by title and summary, 94 articles were chosen for review of the full text. Different surgical techniques were found; TURP by monopolar or bipolar method, open prostatectomy, plasma vaporization, laser techniques, minimally invasive ablative techniques. Most articles compare TURP-B (gold standard) vs other surgical methods; focusing on clinical outcomes based on IPSS score, Qmax, PVR and Qol scales; Observing similar results among all the techniques.
Conclusions: TURP-B is the most practiced technique for the management of BPH, with good results compared to TURP-M. Similar results between TURP-B with HoLEP, ThuLEP, Greenlight laser, TUMT. The decision of the surgical technique will be chosen according to the surgeon's expertise and the characteristics of each patient. The results presented here are heterogeneous and require further investigation.
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