Abstract
BackgroundTo compare the clinical efficiency and safety of transurethral resection of the prostate (TURP) and prostatic artery embolization (PAE) for the treatment of Benign prostatic hyperplasia (BPH).MethodsWe searched PUBMED, EMBASE and the Cochrane Central Register for studies from May 1998 to May 2018 for studies comparing the efficiency and safety of TURP with PAE. Four studies met the inclusion criteria for our meta-analysis. After data extraction and quality assessment, we used RevMan 5.2 to pool the data.ResultsA total of four studies involving 506 patients were included in our meta-analysis. The pooled data showed that the Qmax was higher in TURP group than PAE with a significant difference (WMD:4.66, 95%CI 2.54 to 6.79, P < 0.05). The postoperative QOL was lower in the TURP than PAE group (WMD: -0.53, 95%CI -0.88 to − 0.18, P < 0.05). The postoperative prostate volume was significantly smaller in the TURP than PAE group (WMD: -8.26, 95%CI -12.64 to − 3.88, P < 0.05). The operative time was significantly shorter in the TURP than PAE group (WMD: -10.55, 95%CI -16.92 to − 4.18, P < 0.05). No significant difference was found in the postoperative IPSS and complications between TURP and PAE (P > 0.05, WMD:1.56, 95%CI -0.67 to 3.78, p = 0,05, OR:1.54, 95%CI 1.00 to2.38, respectively).ConclusionsTURP could achieve improved Qmax and QoL compared to PAE. Therefore, for patients with BPH and lower urinary tract symptoms (LUTS), TURP was superior to PAE.
Highlights
To compare the clinical efficiency and safety of transurethral resection of the prostate (TURP) and prostatic artery embolization (PAE) for the treatment of Benign prostatic hyperplasia (BPH)
The inclusion criteria were as follows: (1) comparative analysis of Transurethral resection of the prostate (TURP) and PAE for treating BPH; (2) BPH patients treated with TURP and PAE; (3) follow-up duration longer than 12 months; and (4) articles with the International prostate symptom score (IPSS), Maximum urinary flow rate/peak urinary flow rate (Qmax), Qol, postoperative prostate, volume, and operative time
Data related to the postoperative IPSS were available in two studies No significant difference between the TURP and PAE groups was noted (n = 87, weight mean difference (WMD): 1.56, 95%confidence interval (CI): -0.67 to 3.78, I2 = 88%; p = 0.17, fixed-effects model, Fig. 3)
Summary
To compare the clinical efficiency and safety of transurethral resection of the prostate (TURP) and prostatic artery embolization (PAE) for the treatment of Benign prostatic hyperplasia (BPH). Treatment options for BPH often include medical waiting, minimally invasive approaches, alpha-1-Blocker, or surgical therapies. Surgical treatments (transurethral resection of the prostate or open surgery) are used for treatment in the event of failed medical management [4]. Transurethral resection of the prostate (TURP) is considered the gold standard of treatment for men with prostate volumes of 30–80 ml, and it is appropriate for those with prostate volumes > 80 ml [1, 5]. Prostatic artery embolization (PAE) has been suggested as a minimally invasive interventional radiological procedure [8].
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