Abstract
PurposeThe goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.MethodsWe conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000–2004, 2005–2009, 2010–2014, and 2015–2022. We assessed International Prostate Symptom Score (IPSS), Peak Flow (Qmax), Post-void residue of urine (PVR), and post-operative complications. Heterogeneity was ranked as low (I2 < 25%), moderate (I2 = 25–75%), or high (I2 > 75%).ResultsTURP significantly improved IPSS, Qmax, and PVR, with the most recent studies showing superior results in IPSS and Qmax after 3 years compared to 2000–2004 studies. Heterogeneity in PVR was high (I2 = 100%). No negative impact on erectile function was observed. Complication rates included TURP syndrome (2%), bleeding (8%), and blood transfusion (6%), but elevated heterogeneity with difference between the groups was seen in clot evacuation (I2 = 83%) and urinary tract infections (I2 = 82%). Other complications were urinary retention (4%), incontinence (8%), urethral stricture (3%), bladder neck stenosis (2%).ConclusionIn the last 20 years there has not been a clear trend in the results of TURP. The found heterogeneity may indicate a lack of standardization in TURP procedures. However, symptomatic improvement among patients is uniform, which supports this procedure as a historical benchmark surgical treatment for BPH.
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