Functional outcomes and complications following transurethral surgical procedures for the treatment of benign prostatic obstruction
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v83i1.950Keywords:
Prostatic hyperplasia, transurethral resection, complications, outcomesAbstract
Introduction: Benign prostatic hyperplasia is a disease that affects men variably over time, affecting their lifestyle with irritative and obstructive urinary symptoms. One treatment option is transurethral resection of the prostate. However, there are currently new, innovative and advantageous transurethral techniques. The aim of this review is to contribute to current knowledge of the different functional outcomes and complications of the main transurethral techniques.
Methods. A literature review was conducted between December 2021 and January 2022 in the PubMed and Cochrane databases. The quality of the articles was assessed by applying PRISMA 2020 and AGREE on II recommendations.
Results. A total of four articles were selected for the final paper. It was determined that there is currently no standard technique for the treatment of benign prostatic hyperplasia; laser enucleation techniques (HoLEP) are a safe option in anticoagulated patients and can be used regardless of prostate size.
Conclusions. The present review highlights the literature gaps regarding the selection of a standard transurethral surgical technique for the treatment of obstructive symptoms secondary to benign prostatic hyperplasia. The use of various types of lasers is recommended in view of improved functional outcomes; M-RTUP is associated with more post-surgical bleeding relative to other techniques. Long-term randomized controlled trials with a larger number of comparisons are needed to outline the best technique. However, the treatment of patients with benign prostatic hyperplasia should be highly individualized.
References
Robles-Rodríguez A, Garibay-Huarte TR, Acosta-Arreguín E, Morales-López S. La próstata: generalidades y patologías más frecuentes. Revista de la Facultad de Medicina UNAM. 2019;62(4): 41–54.
Elshal A, Soltan M, El-Tabey N, Laymon M, Nabeeh H, Nabeeh A. 121 - Challenging large sized benign prostate hyperplasia through randomized trial of bipolar resection vs. holmium laser enucleation vs. Green Light laser vapo-enucleation of the prostate. European Urology Supplements. 2018;17(2): e177–e179. https://doi.org/10.1016/S1569-9056(18)30973-4.
Hernández MB. Hiperplasia prostática benigna. Revista Medica Sinergia. 2017;2(8): 11–16. https://revistamedicasinergia.com/index.php/rms/article/view/91
Almeida FG, Silva LT. BPH treatment: laser for everyone | Opinion: NO. International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology. 2018;44(2): 215–218. https://doi.org/10.1590%2FS1677-5538.IBJU.2018.02.03.
Gravas S, Cornu JN, Gacci M, Gratzke C, Herrmann TRW, Mamoulakis C, et al. EAU Guidelines on the Management of Non-neurogenic Male LUTS , incl. Bening Prostatic Obstruction (BPO). Netherlands: European Association of Urology; 2022. https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts [Accessed 23rd February 2023].
Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, et al. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART I—Initial Work-up and Medical Management. Journal of Urology. 2021;206(4): 806–817. https://doi.org/10.1097/JU.0000000000002183.
Zheng X, Han X, Cao D, Wang Y, Xu H, Yang L, et al. Comparison of Short-Term Outcomes between Button-Type Bipolar Plasma Vaporization and Transurethral Resection for the Prostate: A Systematic Review and Meta-Analysis. International Journal of Medical Sciences. 2019;16(12): 1564–1572. https://doi.org/10.7150%2Fijms.38618.
Wang YB, Yan SY, Xu XF, Huang X, Luo LS, Deng YQ, et al. Comparison on the Efficacy and Safety of Different Surgical Treatments for Benign Prostatic Hyperplasia With Volume >60 mL: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials. American Journal of Men’s Health. 2021;15(6): 15579883211067086. https://doi.org/10.1177/15579883211067086.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología. 2021;74(9): 790–799. https://www.revespcardiol.org/es-declaracion-prisma-2020-una-guia-articulo-S0300893221002748.
AGREE-HS Research Team. Appraisal of Guidelines Research & Evaluation—Health Systems: AGREE-HS. AGREE-HS Research Team; 2018.
Sousa M, Navas Z, Laborde M, José J, Carrascosa U. Niveles de Evidencia Clínica y Grados de Recomendación. Revista de la Sociedad Andaluza de Traumatología y Ortopedia. 2012;29(1): 59–72. https://www.repositoriosalud.es/bitstream/10668/1568/6/Mella_Niveles.pdf
Huang SW, Tsai CY, Tseng CS, Shih MC, Yeh YC, Chien KL, et al. Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysis. BMJ (Clinical research ed.). 2019;367: l5919. https://doi.org/10.1136/bmj.l5919.
Sun F, Sun X, Shi Q, Zhai Y. Transurethral procedures in the treatment of benign prostatic hyperplasia: A systematic review and meta-analysis of effectiveness and complications. Medicine. 2018;97(51): e13360. https://doi.org/10.1097/md.0000000000013360.
Parsons JK, Dahm P, Köhler TS, Lerner LB, Wilt TJ. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Amendment 2020. The Journal of Urology. 2020;204(4): 799–804. https://doi.org/10.1097/ju.0000000000001298.
Homma Y, Gotoh M, Kawauchi A, Kojima Y, Masumori N, Nagai A, et al. Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia. International Journal of Urology: Official Journal of the Japanese Urological Association. 2017;24(10): 716–729. https://doi.org/10.1111/iju.13401.
Anan G, Kaiho Y, Iwamura H, Ito J, Kohada Y, Mikami J, et al. Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study. BMC Urology. 2020;20: 3. https://doi.org/10.1186%2Fs12894-019-0570-5.
Leonardo C, Lombardo R, Cindolo L, Antonelli A, Greco F, Porreca A, et al. What is the standard surgical approach to large volume BPE? Systematic review of existing randomized clinical trials. Minerva Urologica e Nefrologica. 2020;72(1). https://doi.org/10.23736/S0393-2249.19.03589-6.
Elshal AM, Soltan M, El-Tabey NA, Laymon M, Nabeeh A. Randomised trial of bipolar resection vs holmium laser enucleation vs Greenlight laser vapo-enucleation of the prostate for treatment of large benign prostate obstruction: 3-years outcomes. BJU international. 2020;126(6): 731–738. https://doi.org/10.1111/bju.15161.
Teng TC, Shao IH, Hsu YC, Chen Y, Tsao SH, Kang YT, et al. Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study. Clinical Interventions in Aging. 2021;16: 1747–1756. https://doi.org/10.2147%2FCIA.S329468.
Rivera M, Krambeck A, Lingeman J. Holmium Laser Enucleation of the Prostate in Patients Requiring Anticoagulation. Current Urology Reports. 2017;18(10): 77. https://doi.org/10.1007/s11934-017-0727-2.
Davies B. Responsibility and the limits of patient choice. Bioethics. 2020;34(5): 459–466. https://doi.org/10.1111/bioe.12693.
Akan S, Ediz C, Özer E, Pehlivanoğlu M, Tavukçu HH, Kıymaz K, et al. Efficacy and Safety of Monopolar Transurethral Resection of the Prostate on Bleeding Control in the Treatment of Benign Prostatic Obstruction: Is It Still a Good Option in Developing Countries? The Bulletin of Urooncology. 2020;19(3): 157–161. http://dx.doi.org/10.4274/uob.galenos.2020.1655.
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