Novel minimally invasive treatments for lower urinary tract symptoms : a systematic review and network meta-analysis
Copyright® by the International Brazilian Journal of Urology..
PURPOSE: To review and compare the effectivity of novel minimally invasive treatments (MITs) to transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) in men.
METHODS: Medline, Embase, and Cochrane databases were searched from January 2010 to December 2022 for randomized controlled trials (RCTs) evaluating MITs, compared to TURP or sham, in men with LUTS. Studies were assessed by risk of bias tool, and evidence by GRADE. Functional outcomes by means of uroflowmetry and IPSS were the primary outcomes, safety and sexual function were secondary outcomes. As part of this review, a network meta-analysis (NMA) was conducted. MITs were ranked based on functional outcome improvement probability.
RESULTS: In total, 10 RCTs were included, evaluating aquablation, prostatic urethral lift, prostatic artery embolization (PAE), convective water vapor thermal treatment or temporary implantable nitinol device. All MITs showed a better safety profile compared to TURP. Functional outcome improvement following aquablation were comparable to TURP. In the NMA, aquablation was ranked highest, PAE followed with the second highest probability to improve functional outcomes. Other novel MITs resulted in worse functional outcomes compared to TURP. Level of evidence was low to very low.
CONCLUSIONS: Five MITs for treatment of LUTS were identified. Aquablation is likely to result in functional outcomes most comparable to TURP. Second in ranking was PAE, a technique that does not require general or spinal anesthesia. MITs have a better safety profile compared to TURP. However, due to high study heterogeneity, results should be interpreted with caution.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
International braz j urol : official journal of the Brazilian Society of Urology - 49(2023), 4 vom: 26. Juli, Seite 411-427 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van Kollenburg, Robertus Arnoldus Antonius [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 05.06.2023 Date Revised 08.09.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1590/S1677-5538.IBJU.2023.0016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357696441 |
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| 100 | 1 | |a van Kollenburg, Robertus Arnoldus Antonius |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Novel minimally invasive treatments for lower urinary tract symptoms |b a systematic review and network meta-analysis |
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| 500 | |a Date Completed 05.06.2023 | ||
| 500 | |a Date Revised 08.09.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright® by the International Brazilian Journal of Urology. | ||
| 520 | |a PURPOSE: To review and compare the effectivity of novel minimally invasive treatments (MITs) to transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) in men | ||
| 520 | |a METHODS: Medline, Embase, and Cochrane databases were searched from January 2010 to December 2022 for randomized controlled trials (RCTs) evaluating MITs, compared to TURP or sham, in men with LUTS. Studies were assessed by risk of bias tool, and evidence by GRADE. Functional outcomes by means of uroflowmetry and IPSS were the primary outcomes, safety and sexual function were secondary outcomes. As part of this review, a network meta-analysis (NMA) was conducted. MITs were ranked based on functional outcome improvement probability | ||
| 520 | |a RESULTS: In total, 10 RCTs were included, evaluating aquablation, prostatic urethral lift, prostatic artery embolization (PAE), convective water vapor thermal treatment or temporary implantable nitinol device. All MITs showed a better safety profile compared to TURP. Functional outcome improvement following aquablation were comparable to TURP. In the NMA, aquablation was ranked highest, PAE followed with the second highest probability to improve functional outcomes. Other novel MITs resulted in worse functional outcomes compared to TURP. Level of evidence was low to very low | ||
| 520 | |a CONCLUSIONS: Five MITs for treatment of LUTS were identified. Aquablation is likely to result in functional outcomes most comparable to TURP. Second in ranking was PAE, a technique that does not require general or spinal anesthesia. MITs have a better safety profile compared to TURP. However, due to high study heterogeneity, results should be interpreted with caution | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Minimally Invasive Surgical Procedures | |
| 650 | 4 | |a Prostate | |
| 650 | 4 | |a Systematic Review [Publication Type] | |
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| 700 | 1 | |a de Bruin, Daniel Martijn |e verfasserin |4 aut | |
| 700 | 1 | |a de Rijke, Theodorus Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Oddens, Jorg Reinier |e verfasserin |4 aut | |
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