2028 PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE A SYSTEMATIC REVIEW WITH META-ANALYSIS

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology II1 Apr 20122028 PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE A SYSTEMATIC REVIEW WITH META-ANALYSIS Isaac Thangasamy, Venu Chalasani, Alexander Bachmann, and Henry Woo Isaac ThangasamyIsaac Thangasamy Sydney, Australia More articles by this author , Venu ChalasaniVenu Chalasani Sydney, Australia More articles by this author , Alexander BachmannAlexander Bachmann Basel, Switzerland More articles by this author , and Henry WooHenry Woo Sydney, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2191AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Photoselective vaporization of the prostate (PVP) is being increasingly used to treat symptomatic outflow obstruction, due to the lower morbidity associated with this procedure. The aim of this study was to conduct a systematic review and meta-analysis of randomized evidence to determine the effectiveness of PVP versus TURP for surgical treatment of benign prostatic hyperplasia. METHODS A search of biomedical databases from 2002-2011 was combined with a search of the American Urological Association and European Association of Urology conference proceedings from 2007 to 2011. Inclusion criteria were that the trial had to be a randomized controlled trial, intervention had to be PVP, and control had to be TURP. Data extraction was conducted by two independent reviewers. Meta-analysis was performed using a random effects model. Outcome variables analyzed included peri-operative data, short and long term complications, and functional outcomes. RESULTS Seven trials were identified with a total of 367 patients undergoing PVP and 363 undergoing TURP. Length of stay and catheterization time were shorter in the PVP group by 2.23 days (95% CI 1.84 to 2.61) and 1.91 days (95% CI 1.47 to 2.35) respectively. Operation time was shorter in the TURP group by 19.64 minutes (95% CI 9.05 to 30.23). Blood transfusion was significantly less likely in the PVP group (Risk ratio 0.11; 95% CI 0.03-0.40). There were no significant differences between PVP and TURP when comparing other complications. With regard to functional outcomes, five studies found no difference between PVP and TURP while two studies favoured TURP (table 1). Table 1. Auther (et al.) Follow up (months) Q-Max (ml/s) IPSS PVP TURP p value PVP TURP p value Al-Ansari 36 17.2 19.9 NS 11.0 8.6 NS Bouchier-Hayes 12 18.6 19.37 0.491 8.86 10.91 0.124 Capitan 24 18.9 21.98 0.655 8.0 8.57 0.48 Horasanli 6 13.3 20.7 0.02⁎ 13.1 6.4 0.01⁎ Sarica 12 - - Ŝ - - Ŝ Schwartz 11 19 22 NS 5 4 NS Skolarikos 12 18.3 15.42 0.115 9.32 10.00 0.339 Reported maximum flow rate, IPSS score and p value for each study at final follow up. NS = Not significant (p value not reported) ⁎ = statistically significant, Ŝ = statistically significant in favour of TURP (p value not reported) CONCLUSIONS The overall results suggest equivalence in functional outcomes although length of hospital stay, duration of catheterization and blood transfusion requirement appears to favour PVP. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e818 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isaac Thangasamy Sydney, Australia More articles by this author Venu Chalasani Sydney, Australia More articles by this author Alexander Bachmann Basel, Switzerland More articles by this author Henry Woo Sydney, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...