Xin Jian Xu1, Jingjing Li2, Xiang Zhong Huang3, Qiang Liu4. 1. Department of Interventional Radiology, Jiangyin People's Hospital, No. 3, Yingrui Road, Jiangyin, 214400, Jiangsu, China. 2. Department of Radiology, Affiliated Taizhou Hospital of Wenzhou Medical University, Taizhou, 317000, Zhejiang, China. 3. Department of Interventional Radiology, Jiangyin People's Hospital, No. 3, Yingrui Road, Jiangyin, 214400, Jiangsu, China. hxzdoc@163.com. 4. Department of Radiology, Shandong Medical Imaging Research Institute Affiliated To Shandong University, No 324, Warp 5 Weft 7 Street, Huaiyin District, Jinan, 250000, Shandong, China. liuqiangdoc@163.com.
Abstract
OBJECTIVE: To investigate whether prostatic arterial embolization (PAE) could be recommended as a routine therapy for benign prostatic hyperplasia (BPH), we conducted an updated meta-analysis to assess the efficacy and safety of PAE compared with transurethral resection of the prostate (TURP). METHODS: Systematic literature retrieval by searching data from Web of science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang and VIP databases was carried out to identify all related trials from the inception dates to June 2019. We also conducted subgroup analyses depending on the kind of study design, kind of PAE and kind of TURP. RESULTS: Nine studies comparing PAE with TURP involving a total of 860 BPH patients were selected. Postoperative reduced IPSS score (MD 2.50; 95% CI 0.78-4.21; P = 0.004), postoperative reduced QOL score (MD 0.40; 95% CI 0.09-0.71; P = 0.01), postoperative reduced PV (MD 8.59; 95% CI 4.74-12.44; P < 0.00001) and postoperative increased Qmax (MD 2.54; 95% CI 1.02-4.05; P = 0.001) were better in TURP than in PAE; however, PAE was associated with lower sexual dysfunction rate (OR 0.24; 95% CI 0.15-0.39; P < 0.00001) compared with TURP. Meanwhile, no significant difference in postoperative reduced PVR (MD 0.46; 95% CI - 2.08 to 3.00; P = 0.72) and complication (OR 0.57; 95% CI 0.21-1.55; P = 0.27) between PAE and TURP group was demonstrated. CONCLUSION: PAE was inferior to TURP in the improvement of postoperative IPSS, QOL, PV, Qmax and TURP still remained the gold standard. However, PAE may be a valuable alternative to TURP in the treatment of BPH patients who refuse surgery or with surgery contraindication.
OBJECTIVE: To investigate whether prostatic arterial embolization (PAE) could be recommended as a routine therapy for benign prostatic hyperplasia (BPH), we conducted an updated meta-analysis to assess the efficacy and safety of PAE compared with transurethral resection of the prostate (TURP). METHODS: Systematic literature retrieval by searching data from Web of science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang and VIP databases was carried out to identify all related trials from the inception dates to June 2019. We also conducted subgroup analyses depending on the kind of study design, kind of PAE and kind of TURP. RESULTS: Nine studies comparing PAE with TURP involving a total of 860 BPHpatients were selected. Postoperative reduced IPSS score (MD 2.50; 95% CI 0.78-4.21; P = 0.004), postoperative reduced QOL score (MD 0.40; 95% CI 0.09-0.71; P = 0.01), postoperative reduced PV (MD 8.59; 95% CI 4.74-12.44; P < 0.00001) and postoperative increased Qmax (MD 2.54; 95% CI 1.02-4.05; P = 0.001) were better in TURP than in PAE; however, PAE was associated with lower sexual dysfunction rate (OR 0.24; 95% CI 0.15-0.39; P < 0.00001) compared with TURP. Meanwhile, no significant difference in postoperative reduced PVR (MD 0.46; 95% CI - 2.08 to 3.00; P = 0.72) and complication (OR 0.57; 95% CI 0.21-1.55; P = 0.27) between PAE and TURP group was demonstrated. CONCLUSION:PAE was inferior to TURP in the improvement of postoperative IPSS, QOL, PV, Qmax and TURP still remained the gold standard. However, PAE may be a valuable alternative to TURP in the treatment of BPHpatients who refuse surgery or with surgery contraindication.
Entities:
Keywords:
Benign prostatic hyperplasia; Meta-analysis; Prostatic arterial embolization; Transurethral resection of the prostate
Authors: Kevin T McVary; Claus G Roehrborn; Andrew L Avins; Michael J Barry; Reginald C Bruskewitz; Robert F Donnell; Harris E Foster; Chris M Gonzalez; Steven A Kaplan; David F Penson; James C Ulchaker; John T Wei Journal: J Urol Date: 2011-03-21 Impact factor: 7.450
Authors: Matthias Oelke; Alexander Bachmann; Aurélien Descazeaud; Mark Emberton; Stavros Gravas; Martin C Michel; James N'dow; Jørgen Nordling; Jean J de la Rosette Journal: Eur Urol Date: 2013-03-13 Impact factor: 20.096
Authors: Harris E Foster; Michael J Barry; Philipp Dahm; Manhar C Gandhi; Steven A Kaplan; Tobias S Kohler; Lori B Lerner; Deborah J Lightner; J Kellogg Parsons; Claus G Roehrborn; Charles Welliver; Timothy J Wilt; Kevin T McVary Journal: J Urol Date: 2018-06-11 Impact factor: 7.450
Authors: Alistair F Ray; John Powell; Mark J Speakman; Nicholas T Longford; Ranan DasGupta; Timothy Bryant; Sachin Modi; Jonathan Dyer; Mark Harris; Grace Carolan-Rees; Nigel Hacking Journal: BJU Int Date: 2018-05-06 Impact factor: 5.588
Authors: Francisco C Carnevale; Alexandre Iscaife; Eduardo M Yoshinaga; Airton Mota Moreira; Alberto A Antunes; Miguel Srougi Journal: Cardiovasc Intervent Radiol Date: 2015-10-27 Impact factor: 2.740
Authors: Dominik Abt; Lukas Hechelhammer; Gautier Müllhaupt; Stefan Markart; Sabine Güsewell; Thomas M Kessler; Hans-Peter Schmid; Daniel S Engeler; Livio Mordasini Journal: BMJ Date: 2018-06-19