Efficacy and Safety of TUEVP vs TURP for the Treatment of Benign Prostatic Hyperplasia / 医学研究杂志

ABSTRACT

Objective To evaluate the efficacy and safety of TUEVP vs TURP for treating benign prostatic hyperplasia(BPH).MethodsLiferatures on randomized controlled trials(RCT),non-randomized controlled trials(NRCT) and retrospective controlled trials of both Chinese and English studies about TUEVP vs TURP for the treatment of BPH all over the world were searched by Pubmed,Ovid,ScineceDirect,NGC,EBSCO,EMBASE,CNKI,CBM,as well as manual search of four Chinese journals: Chinese of Journal of Androloy,National Journal of Androlgy,Chinese Journal of Urology,Journal of Clinical Urology.Two reviewers independently screened the studies for eligibility,evaluated the quality and extracted the data from the eligible studies,with confirmation by cross-checking.Divergences of opinion were settled by discussion or consulted by the expert.Meta-analysis was processed by Rev Man 5.0,fail-safe number(Nfs) was performed by SAS8.0.ResultsSeventeen RCTs involving 2413 men were enrolled the inclusion criteria in Meta analysis.The baseline of patients' characteristics was comparable in all the studies.By evaluating the relevant indicators,side effects and complications between TUEVP and TURP,the statistically significant differences of pooled estimates suggested a benefit of TUEVP over TURP for bladder wash-out time,catheterization time,hospital stay,incidence of ED(20.6% vs 29.0%).In contrast,pooled estimates of the difference favoured TURP over TUEVP for MFR and incidence of postoperative secondary hemorrhage(7.9% vs 3.6%).ConclusionThis formal meta-analysis suggests that both TUEVP and TURP in patients with BPH provide comparable improvements,whose efficacy and safety is similar.While comparative analysis is limited by the methodological shortcomings of the underlying studies and the short follow-up,both TURP and TUEVP may offer distinct advantages.More high quality trials with large sample and longer follow-up are proposed,which will provide more evidence about evidence based medicine.