TURis Plasma Vaporization
This study sought to evaluate the efficacy and safety of Vaporisation BPH Komplikationen vaporisation PVP vs. The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy primary outcomes: maximum urinary flow rate Q maxinternational prostate symptom score IPSSpostvoid residual urine PVR and quality of life QoL ; secondary outcomes: operative time, hospital time and catheter removal time and safety complications, such as Vaporisation BPH Komplikationen and capsular perforation were explored by using Review Manager 5.
Six randomized controlled trials RCTs and five case-controlled studies of patients met the inclusion criteria. Due Vaporisation BPH Komplikationen the different energy settings Vaporisation BPH Komplikationen for green-light laser sources Vaporisation BPH Komplikationen the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether different energy settings affect outcomes.
Benign prostatic hyperplasia BPH is a major cause of lower urinary tract symptoms LUTSs in men, especially in individuals over the age of Vaporisation BPH Komplikationen years. Therefore, this meta-analysis was designed to provide more reliable evidence of the efficacy and safety of PVP vs. We also searched the references of included studies to identify additional, potentially relevant studies.
The searches were not restricted by publication year or language. All titles and abstracts retrieved via electronic searches were screened independently by two reviewers. Secondary outcomes were operative time, hospital time, catheter removal time and complications, such as transfusion and capsular perforation, among others.
The relevant data were extracted independently by two reviewers. The methodological quality of the included RCT studies, which included Vaporisation BPH Komplikationen of sequence generation, allocation concealment, blinding, incomplete outcome data, selective reporting of outcomes and other possible sources of bias, was assessed using the Cochrane Collaboration's tool.
The quality assessment was performed independently by two reviewers. Disagreements were resolved in Vaporisation BPH Komplikationen with the third reviewer. We analysed the data using Review Manager version 5. Data were pooled using the random-effects model. Where data were available and sufficient, subgroup analyses were performed to explore possible heterogeneity by grouping the trials into an RCT group and a non-RCT group. Subgroup analyses were performed to explore the influence of the size of the prostate.
Two hundred and four potential studies were identified from the above electronic databases. Following study assessment, we identified 11 trials 1011121920212223242526 including six RCTs and five prospective case-controlled studies CCSs that met our including criteria Table 1.
Two trials of patients were not available because we were unable to obtain the data for inclusion in this meta-analysis. In Table 1we show the characteristics Vaporisation BPH Komplikationen the 11 studies included in Vaporisation BPH Komplikationen meta-analysis.
Quality assessment showed that five CCSs were of high quality. Although only two RCTs 1012 were adequate in sequence generation and incomplete outcome data but inadequate in allocation concealment and blinding and three RCTs 111920 were adequate in sequence generation, allocation concealment and incomplete outcome data but inadequate in blinding, they were regarded as high quality because of the limitation of ethics factor and the characteristics of the surgery studies.
One RCT 22 reported only randomisation but inadequate allocation concealment, blinding and incomplete outcome data and was regarded as low quality. However, the included studies had several limitations. We contacted the authors to obtain Vaporisation BPH Komplikationen data but nothing was provided. Vaporisation BPH Komplikationen, these data were not included in this meta-analysis.
Data from six available studies of patients Vaporisation BPH Komplikationen Q max for PVP vs. We performed a meta-analysis using a random-effects model. There were no significant heterogeneities revealed by the pooled analysis. Data from seven available studies of patients showed operative time Vaporisation BPH Komplikationen PVP vs.
Data from seven available studies of patients described hospital time for PVP vs. Data from eight available studies of patients described catheter removal time for PVP vs.
Ten studies reported complications including blood transfusion, capsular perforation, incidences of TUR syndrome, clot retention, urinary retention, urinary tract infection, reintervention, retrograde ejaculation, urethral stricture, urinary incontinence, bladder neck contracture and dysuria. One former systematic review has reviewed PVP vs. For our systematic review and meta-analysis, Vaporisation BPH Komplikationen generated a precise and detailed retrieval strategy.
By doing so, we expected to include all of the studies related to BPH for a comparison between PVP and TURP and hoped to reduce confounds and biases and ultimately draw a scientifically and statistically robust conclusion.
It is well known that RCTs are considered the gold standard trial design for evaluating and comparing interventions by reducing bias to a minimum. Although both procedures had the same efficacy, long-term follow-up after 24 months will be required.
Our pooled analyses and sensitivity analyses for hospital time and Vaporisation BPH Komplikationen removal time showed that PVP results in clearly shorter times than TURP, whereas operative time is longer than that of TURP despite the existing heterogeneity in the trials. Because surgeons have different Vaporisation BPH Komplikationen in the techniques, we believe that the inconsistency in operative time does not affect the validity of our conclusion.
With respect to the rate of complications including blood transfusion, capsular perforation, incidences of TUR syndrome and clot retention, our results showed that there were significantly fewer incidences of complications following PVP compared with TURP.
The main complication of traditional TURP is bleeding, which often requires a transfusion. Our meta-analysis showed that the Vaporisation BPH Komplikationen rate, capsular perforation, incidence of TUR syndrome and clot retention was 0.
The treatment of symptomatic BPH causes an important effect on male sexual function, with an incidence of ejaculatory dysfunction at approximately TURP: Stovsky et al. The likely primary reason underlying this difference is that PVP induces less morbidity and is associated with shorter hospital time than TURP.
An important disadvantage of laser prostatectomy Vaporisation BPH Komplikationen the lack of tissue obtained during Vaporisation BPH Komplikationen operation, which precludes the identification of incidental prostate cancer.
Therefore, it is important to evaluate patients carefully with both digital rectal examinations and prostate-specific antigen measurements and by using transrectal ultrasonography and biopsies where cancer is suspected. Our meta-analysis also had several limitations.
First, one RCT reported using W-laser procedures and two RCTs reported using W-laser procedures, both of which were included in our study, and one RCT 10 reported IPSS, Q max and QoL data in the form of box-plots Vaporisation BPH Komplikationen bar charts, and this information could not be extracted for meta-analysis Vaporisation BPH Komplikationen different green-light laser wattages.
Heinrich et al. Subsequently, Malek et al. These data indicate the requirement for more clinical RCTs comparing higher wattage with lower wattage to verify these Vaporisation BPH Komplikationen.
Second, the lack of relevant data on the time to recovery of erectile function, on International Index of Erectile Function scores, on patients with or without anticoagulant therapy and on monopolar or bipolar TURP precludes further evaluation on these endpoints. Third, because of the small sample size and the limited methodological quality of the studies included, more analyses of higher-quality, large-sample, long-term RCTs where outcomes Vaporisation BPH Komplikationen described in detail are required.
Because of the different energy settings of green-light laser sources, more analyses of higher-quality, large-sample, long-term RCTs are required to verify the effects of different energy settings. All authors read and approved the final manuscript.
National Center for Biotechnology InformationU. Journal List Asian J Androl v. Asian J Androl. Published online Aug Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract This study sought to evaluate the efficacy and safety of photoselective vaporisation PVP vs.
Introduction Benign prostatic hyperplasia BPH Vaporisation BPH Komplikationen a major cause of lower urinary tract symptoms LUTSs in men, especially in individuals over the age of 50 years. Statistical analysis We analysed the data using Review Manager version 5. Results Two hundred Vaporisation BPH Komplikationen four potential studies were identified from the above electronic databases. Study Design No. Open in a separate window. Operative time Data from seven available studies of patients showed operative time for PVP vs.
Hospital time Data from seven available studies of patients described hospital time for PVP vs. Catheter removal time Data from eight available studies of patients described catheter removal time for PVP vs.
Complication rate Ten studies reported complications including blood transfusion, capsular perforation, incidences of TUR syndrome, clot retention, urinary retention, urinary tract infection, reintervention, retrograde ejaculation, urethral stricture, urinary incontinence, bladder neck contracture and dysuria. Notes The authors have no financial or commercial interests related to this study. The development of human benign prostatic hyperplasia with age.
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