scholarly journals Meta-analysis of the efficacy and safety of combination of tamsulosin plus dutasteride compared with tamsulosin monotherapy in treating benign prostatic hyperplasia

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhongbao Zhou ◽  
Yuanshan Cui ◽  
Jitao Wu ◽  
Rui Ding ◽  
Tong Cai ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Efficacy And Safety

scholarly journals Meta-Analysis of Efficacy and Safety of Tadalafil Plus Tamsulosin Compared with Tadalafil Alone in Treating Men with Benign Prostatic Hyperplasia and Erectile Dysfunction

2019 ◽  
Vol 13 (5) ◽  
pp. 155798831988259 ◽  
Author(s):  
Zhongbao Zhou ◽  
Xuesong Zheng ◽  
Jitao Wu ◽  
Zhenli Gao ◽  
Zhunan Xu ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
The Difference ◽  
Meta Analyses

This meta-analysis was performed to evaluate the efficacy and safety of tadalafil plus tamsulosin compared with tadalafil alone in treating men with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) after 12 weeks’ treatment. Systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched to collect randomized controlled trials. The references of related articles were also searched. Four articles including 621 patients were involved in the analysis. The study identified that combination-therapy had significant improvements in total international prostate symptom score (IPSS), quality of life (QoL) and maximum urine flow rate (Qmax) compared with monotherapy, and there were no obvious significance in respects of post-void residual volume, international index of erectile function and IPSS storage. The difference of total IPSS was mainly reflected in the change of IPSS voiding. For safety, combination-therapy had a higher incidence rate of any adverse events (AEs) and discontinuation due to AEs than monotherapy with the exception of pain. In conclusion, the combination of tadalafil and tamsulosin provided a better improvement of IPSS voiding, QoL and Qmax compared with tadalafil alone in treating men with BPH and ED, and the former therapy appeared to show a higher incidence of AEs.

scholarly journals Efficacy and safety of transurethral split of prostate for benign prostatic hyperplasia: a meta-analysis

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yiyu Huang ◽  
Jiaxin LI ◽  
Shan Yang ◽  
Daozhang Yuan ◽  
Shusheng Wang
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Efficacy And Safety

scholarly journals Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysis

BMJ ◽  
2019 ◽  
pp. l5919 ◽  
Author(s):  
Shi-Wei Huang ◽  
Chung-You Tsai ◽  
Chi-Shin Tseng ◽  
Ming-Chieh Shih ◽  
Yi-Chun Yeh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Diode Laser ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Efficacy And Safety ◽  
Laser Enucleation ◽  
Randomised Controlled ◽  
Surgical Treatments ◽  
Holmium Laser Enucleation

Abstract Objective To assess the efficacy and safety of different endoscopic surgical treatments for benign prostatic hyperplasia. Design Systematic review and network meta-analysis of randomised controlled trials. Data sources A comprehensive search of PubMed, Embase, and Cochrane databases from inception to 31 March 2019. Study selection Randomised controlled trials comparing vapourisation, resection, and enucleation of the prostate using monopolar, bipolar, or various laser systems (holmium, thulium, potassium titanyl phosphate, or diode) as surgical treatments for benign prostatic hyperplasia. The primary outcomes were the maximal flow rate (Qmax) and international prostate symptoms score (IPSS) at 12 months after surgical treatment. Secondary outcomes were Qmax and IPSS values at 6, 24, and 36 months after surgical treatment; perioperative parameters; and surgical complications. Data extraction and synthesis Two independent reviewers extracted the study data and performed quality assessments using the Cochrane Risk of Bias Tool. The effect sizes were summarised using weighted mean differences for continuous outcomes and odds ratios for binary outcomes. Frequentist approach to the network meta-analysis was used to estimate comparative effects and safety. Ranking probabilities of each treatment were also calculated. Results 109 trials with a total of 13 676 participants were identified. Nine surgical treatments were evaluated. Enucleation achieved better Qmax and IPSS values than resection and vapourisation methods at six and 12 months after surgical treatment, and the difference maintained up to 24 and 36 months after surgical treatment. For Qmax at 12 months after surgical treatment, the best three methods compared with monopolar transurethral resection of the prostate (TURP) were bipolar enucleation (mean difference 2.42 mL/s (95% confidence interval 1.11 to 3.73)), diode laser enucleation (1.86 (−0.17 to 3.88)), and holmium laser enucleation (1.07 (0.07 to 2.08)). The worst performing method was diode laser vapourisation (−1.90 (−5.07 to 1.27)). The results of IPSS at 12 months after treatment were similar to Qmax at 12 months after treatment. The best three methods, versus monopolar TURP, were diode laser enucleation (mean difference −1.00 (−2.41 to 0.40)), bipolar enucleation (0.87 (−1.80 to 0.07)), and holmium laser enucleation (−0.84 (−1.51 to 0.58)). The worst performing method was diode laser vapourisation (1.30 (−1.16 to 3.76)). Eight new methods were better at controlling bleeding than monopolar TURP, resulting in a shorter catheterisation duration, reduced postoperative haemoglobin declination, fewer clot retention events, and lower blood transfusion rate. However, short term transient urinary incontinence might still be a concern for enucleation methods, compared with resection methods (odds ratio 1.92, 1.39 to 2.65). No substantial inconsistency between direct and indirect evidence was detected in primary or secondary outcomes. Conclusion Eight new endoscopic surgical methods for benign prostatic hyperplasia appeared to be superior in safety compared with monopolar TURP. Among these new treatments, enucleation methods showed better Qmax and IPSS values than vapourisation and resection methods. Study registration CRD42018099583.

scholarly journals Systematic review and meta-analysis of efficacy and safety of silodosin in treatment of benign prostatic hyperplasia patients with lower urinary tract symptoms

2020 ◽  
Author(s):  
Chi Yuan ◽  
Zhongyu Jian ◽  
Yucheng Ma ◽  
Menghua Wang ◽  
Qibo Hu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract ◽  
Meta Analysis ◽  
Prostatic Hyperplasia ◽  
Efficacy And Safety ◽  
P Values ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Abstract Background: Silodosin is a new high-selective α1A-adrenoceptors antagonist. A systematic review of literature and meta-analysis were performed to compare the clinical efficacy and safety outcomes of silodosin with placebo, tamsulosin, naftopidil and alfuzosin in treating benign prostatic hyperplasia (BPH) males with lower urinary tract symptoms (LUTS). Materials and Methods: We systematically searched literature among EMBASE, PubMed, Cochrane Library, ScienceDirect and Web of Science databases until April 2019. 18 related randomized controlled trials were included according to eligibility criteria. Random-effects model were applied for data analysis. Results: 5,985 patients were included in our study. Silodosin presented superiority to placebo in improving LUTS and better efficacy than tamsulosin and naftopidil in improving IPSS void subscore and post-void residual urine volume with statistically significance (all P values < 0.05). Greater QoL index improvement were found in silodosin than alfuzosin groups (MD = -0.44, 95%CI: [-0.83, -0.05], P = 0.03) while no differences in total IPSS score and Qmax changes between these two groups. Retrograde ejaculation was significantly frequent in silodosin than placebo, tamsulosin and naftopidil groups (all P values < 0.05). Besides, silodosin increased incidence of upper respiratory tract infection compared to tamsulosin groups (RR = 0.69, 95%CI: [0.50, 0.96], P = 0.03). A higher rate of nasal congestion (RR = 7.76, 95%CI: [1.80, 33.41], P = 0.006) were found in silodosin than placebo groups while no difference for nasopharyngitis ((RR = 1.16, 95%CI: [0.54, 2.47], P = 0.71). Prevalence of headache (RR = 0.54, 95%CI: [0.27, 1.06], P = 0.07) and postural hypotension (RR = 0.14, 95%CI: [0.03, 0.77], P = 0.02) were lower in silodosin than tamsulosin groups, although dizziness and vertigo was more frequent in silodosin than placebo (RR = 2.26, 95%CI: [1.21, 4.21], P = 0.009). Conclusions: Our study demonstrated silodosin’s possible superiority to placebo and naftopidil while noninferiority to tamsulosin and alfuzosin in LUTS improvement of BPH males. Better cardiovascular safety was in silodosin groups, although incidence of retrograde ejaculation and respiratory adverse events were higher.

scholarly journals Meta-Analysis of the Efficacy and Safety of Imidafenacin for Overactive Bladder Induced by Benign Prostatic Hyperplasia in Men Receiving Alpha-Blocker Therapy

2020 ◽  
Vol 24 (4) ◽  
pp. 365-374
Author(s):  
Tong Cai ◽  
Ning Wang ◽  
Liye Liang ◽  
Zhongbao Zhou ◽  
Yong Zhang ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Overactive Bladder ◽  
Symptom Score ◽  
Meta Analysis ◽  
Maximum Flow ◽  
Prostatic Hyperplasia ◽  
Cochrane Library ◽  
Systematic Research ◽  
Efficacy And Safety ◽  
Alpha Blocker

Purpose: The aim of this meta-analysis was to evaluate the efficacy and safety of imidafenacin for overactive bladder (OAB) induced by benign prostatic hyperplasia (BPH) in men receiving alpha-blocker monotherapy.Methods: We performed a systematic research of the PubMed, Embase, and Cochrane Library databases, and searched for studies about alpha-blocker with or without imidafenacin treatment for OAB in patients with BPH. We also investigated the original references of the included texts.Results: Four randomized controlled trials including 779 participants with BPH (389 in the alpha-blocker+imidafenacin group and 390 in the alpha-blocker only group) were studied. The main efficacy endpoint was the Overactive Bladder Symptom Score, which showed a mean difference of -1.88 (95% confidence interval, -2.32 to -1.44; P<0.00001), suggesting that alpha-blocker and imidafenacin treatment was effective in treating men with OAB. As other primary efficacy end points, the International Prostate Symptom Score (IPSS) total score (P=0.47), the IPSS storage symptom score (P=0.07), the IPSS voiding symptom score (P=0.60), and the IPSS quality of life score (P=0.18) indicated that 2 methods had no significant differences in treating men with OAB. In terms of safety, which was assessed using postvoid residual volume (P=0.05) and maximum flow rate (P=0.53), the analysis suggested that combination treatment was very well tolerated.Conclusions: This study suggested that imidafenacin plus alpha-blocker was an efficacious and safe treatment for OAB symptoms in BPH patients.

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