scholarly journals Comparison of the Efficacy and Safety of Minimally Invasive Simple Prostatectomy and Endoscopic Enucleation of Prostate for Large Benign Prostatic Hyperplasia

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinze Li ◽  
Dehong Cao ◽  
Chunyang Meng ◽  
Zhongyou Xia ◽  
Lei Peng ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Minimally Invasive ◽  
Maximum Flow ◽  
Pooled Analysis ◽  
Prostatic Hyperplasia ◽  
Significant Heterogeneity ◽  
Efficacy And Safety ◽  
Simple Prostatectomy ◽  
Comprehensive Search ◽  
Endoscopic Enucleation

Background: Minimally invasive simple prostatectomy (MISP) and endoscopic enucleation of the prostate (EEP) are the two most commonly used methods for large benign prostatic hyperplasia (BPH), but it remains unclear which of the two is superior. This study aims to perform a pooled analysis to compare efficacy and safety profiles between MISP and EEP.Methods: We conducted a comprehensive search of PubMed, Embase, Web of Science, and ClinicalTrials.gov databases to identify eligible studies comparing MISP with EEP. Parameters including efficacy and safety outcomes were compared using Stata 14.0 version.Results: Eight comparative trials with 1,504 patients were included. Compared to MISP, EEP demonstrated shorter operative time (mean difference [MD] 46.37, 95% confidence interval [CI] 19.92 to 72.82, p = 0.0006), lesser hemoglobin decrease (standardized MD [SMD] 0.59, 95% CI 0.23 to 0.95, p = 0.001), lower catheterization time (SMD 4.13, 95% CI 2.16 to 6.10, p < 0.001), and shorter length of stay (SMD 2.38, 95% CI 1.40 to 3.36, p < 0.001). However, overall complications and blood transfusions did not differ between the two groups. Moreover, EEP had better postvoid residual volume (PVR) at 6-month (MD 14.39, 95% CI 11.06 to 17.72, p < 0.001) and comparable 3- and 6-month International Prostate Symptom Score, 3- and 6-month maximum flow rate, 3-month PVR, and 3-month quality of life compared with MISP.Conclusion: Both MISP and EEP are effective and safe surgical procedures for the treatment of large BPH. EEP appears to have a superior perioperative profile compared to MISP. This should be interpreted with caution due to the significant heterogeneity between studies. Hence, treatment selection should be based on the surgeon's experience and availability.

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.

scholarly journals Minimally invasive simple prostatectomy for a case of giant benign prostatic hyperplasia

2017 ◽  
Vol 19 (6) ◽  
pp. 717 ◽  
Author(s):  
Wei-Lie Hu ◽  
Qin-Song Zeng ◽  
Yong-Bin Zhao ◽  
Bang-Qi Wang ◽  
Min Ying
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Minimally Invasive ◽  
Prostatic Hyperplasia ◽  
Simple Prostatectomy

scholarly journals Botulinum Neurotoxin Type A for the Treatment of Benign Prostatic Hyperplasia: Randomized Study Comparing Two Doses

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
René Arnouk ◽  
Carlos Henrique Suzuki Bellucci ◽  
Roberto Benatuil Stull ◽  
José de Bessa Junior ◽  
Cesar Augusto Malave ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Botulinum Neurotoxin ◽  
Prostate Volume ◽  
Randomized Study ◽  
Maximum Flow ◽  
Type A ◽  
Prostatic Hyperplasia ◽  
Efficacy And Safety ◽  
International Prostatic Symptom Score ◽  
Botulinum Neurotoxin Type A

Purpose. To assess the efficacy and safety of intraprostatic injection of two botulinum neurotoxin type A (BoNT-A) doses for the treatment of benign prostatic hyperplasia (BPH).Materials and Methods. Men with symptomatic BPH who failed medical treatment were randomized to receive 100 U or 200 U of BoNT-A into the prostate. The International Prostatic Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual volume (PVR), PSA levels and prostate volume before injection and after 3 and 6 months were evaluated. Adverse events were compared between the groups.Results. Thirty four patients were evaluated, including 17 in the BoNT-A 100 U group and 17 in the BoNT-A 200 U group. Baseline characteristics were similar in both groups. Both doses produced significant improvements in IPSS, Qmaxand PVR after 3 and 6 months and both doses promoted comparable effects. Prostate volume was affected by 200 U BoNT-A injection only after 6 months of treatment. PSA levels were significantly affected in the 100 U group only after 6 months of treatment. In the 200 U group, PSA levels were significantly decreased after 3 and 6 months. The complication rate was similar in both groups.Conclusions. Efficacy and safety of both BoNT-A doses are similar for BPH treatment in the short term followup.

scholarly journals Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review

2021 ◽  
Vol 10 (24) ◽  
pp. 5788
Author(s):  
Nicolas Couteau ◽  
Igor Duquesne ◽  
Panthier Frédéric ◽  
Nicolas Thiounn ◽  
Marc-Olivier Timsit ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Surgical Techniques ◽  
Final Analysis ◽  
Prostatic Hyperplasia ◽  
Initial Evaluation ◽  
Laser Source ◽  
Reductase Inhibitors ◽  
Urinary Tract Symptoms ◽  
Simple Prostatectomy ◽  
Endoscopic Enucleation

Background: Benign prostatic hyperplasia (BPH) is commonly responsible for lower urinary tract symptoms (LUTS) in men aged 50 or over. Sexual dysfunctions, such as ejaculatory disorders (EjD), go along with LUTS but are frequently overlooked in the initial evaluation. This review aimed to detail BPH-related EjD, as well as their modifications by medical, surgical, and interventional treatments. Methods: We conducted a narrative review looking for publications between 1990 and 2020, regarding physiopathology, epidemiology, evaluation, and therapeutic management (medical, surgical, and interventional) of BPH-related EjD. Results: Sixty-five articles were included in our final analysis. Forty-six percent of men presenting with LUTS reported EjD. If the prevalence increases with age and LUTS severity, the functional impairment is not correlated with age. Several self-questionnaires evaluated the sexual function, but only four approaches are specific to EjD. Medical therapies were exposed to anejaculation, rather than retrograde ejaculation (RE) (4–30% (alpha-blockers), 4–18% (5-alpha-reductase inhibitors)). Regarding surgical therapies, trans-urethral resection of the prostate (TURP) and incision of the prostate (TUIP) are associated with 50–70% and 21–35% of RE. The RE rate is important after open simple prostatectomy but can be reduced with robotic approaches and urethral sparing techniques (19%). Anatomic endoscopic enucleation of the prostate (AEEP) with or without a laser source is associated with an 11–36% RE rate, according to supramontanal preservation. Recent surgical techniques (Rezum©, Aquablation©, or Urolift©) were developed to preserve antegrade ejaculation with promising short-term results. Regardless of the surgical approach, anatomic studies suggest that the preservation of peri-montanal tissue (7.5 mm laterally; 10 mm proximally) is primordial to avoid post-operative RE. Finally, prostate artery embolization (PAE) limits the RE rate but exposes it to a 12 months 10% re-intervention rate. Conclusion: EjD concerns almost half of the patients presenting BPH-related LUTS. Initial evaluation of EjD impairment is primordial before medical or surgical therapy. Peri-montanal tissue preservation represents a key point for antegrade ejaculation preservation, regardless of the surgical option.

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