医学
随机对照试验
观察研究
荟萃分析
前列腺切除术
前列腺
增生
栓塞
良性前列腺增生(BPH)
泌尿科
开放性前列腺切除术
经尿道前列腺电切术
不利影响
外科
内科学
癌症
作者
Rachel MacKay Altman,Roseanne Ferreira,Camilo Barragán,Naeem Bhojani,Katherine Lajkosz,Kevin C. Zorn,Bilal Chughtai,Ganesan Annamalai,Dean Elterman
出处
期刊:BMC Urology
[Springer Nature]
日期:2024-01-28
卷期号:24 (1)
标识
DOI:10.1186/s12894-023-01397-1
摘要
Abstract Background To summarize current evidence to report a comparative systematic review and meta-analysis of prostatic artery embolization (PAE) with transurethral resection of the prostate (TURP) and open simple prostatectomy (OSP) for the treatment of benign prostatic hyperplasia (BPH). Methods A systematic literature search was performed to identify studies published from inception until August 2021. The search terms used were (prostate embolization OR prostatic embolization) AND (prostatic hyperplasia OR prostatic obstruction) as well as the abbreviations of PAE and BPH. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for observational studies. Random-effects meta-analysis was performed using Revman 5.4. Results Seven studies were included with 810 patients: five RCTs and one observational study compared PAE with TURP, and one observational study compared PAE with OSP. The included studies had considerable risk of bias concerns. TURP and OSP were associated with more statistically significant improvements in urodynamic measures and BPH symptoms compared to PAE. However, PAE seems to significantly improve erectile dysfunction compared to OSP and improve other outcome measures compared to TURP, although not significantly. PAE appeared to reduce adverse events and report more minor complications compared with TURP and OSP, but it is unclear whether PAE is more effective in the long-term. Conclusion PAE is an emerging treatment option for patients with symptomatic BPH who cannot undergo surgery or have undergone failed medical therapy. Overall, PAE groups reported fewer adverse events. Future ongoing and longer-term studies are needed to provide better insight into the benefit of PAE compared to other treatment options.
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