The Outcome And Satisfaction Of Patients Of LUTS Due To Benign Prostatic Hyperplasia And Detrusor Underactivity Following Transurethral Resection Of The Prostate:A Meta-Analysis

Background:Transurethral resection of the prostate (TURP) had been proved to be the gold standard treatment for symptomatic benign prostatic obstruction, but Whether TURP is still suitable for the patients suffering from benign prostatic hyperplasia with detrusor underactivity is still controversial. We undertook a meta-analysis of published studies to assess the effects of TURP on the clinical outcomes of benign prostatic hyperplasia with detrusor underactivity patients.Methods:A systematic literature review was conducted, searching Medline, Embase (1974-2015.4.10) and reference lists for relevant studies. All selected articles were reviewed independently by two, and, in case of discordance, three, reviewers. The meta-analysis was performed with the fixed or random-effect models according to the heterogeneity.Result:Nine studies published between January1998and January2014involving404patients met our inclusion criteria. Among these studies, follow-up duration ranged from3to144months. The studies evaluated were of moderate to poor quality with small sample sizes. The meta-analysis of the extractable data indicates that TURP significantly improves LUTS patients due to BPH with DU in QoL, IPSS, PVR and Qmax:QoL at3months, MD=-2.27,95%CI=-2.50-2.04, P＜0.00001. QoL at12months, MD=-2.23,95%CI=-2.50-1.95, P＜0.00001; IPSS at3months, MD=-9.38,95%CI=-10.02～-.73, P＜0.00001. IPSS at12months, MD=-10.23,95%CI=-14.72～-5.74,p＜0.00001; Qmax at3months, MD=6.19,95%CI=4.81～7.56, P＜0.00001. Qmax at12months, MD=5.66,95% CI=1.92～9.4, P=0.003; PVR at3months, MD=-27.50,95%CI=-32.92～-22.09, P<0.00001. PVR at12months, MD=-142.25,95%CI=-246.67～-37.82, P=0.008.Conclusions:Current evidence indicate that detrusor underactivity (DU) may not be a contraindication to TURP. The patients with LUTS suffering from symptomatic BPH and DU get QoL, IPSS, Qmax and PVR improvement from TURP for at least one year. However, the results should be interpreted cautiously due to the heterogeneity among study designs. With respect to the role of TURP on the long-term outcome in LUTS patients due to symptomatic BPH and DU, the results of this review indicate that there are insufficient data to define this with any degree of accuracy. Further large-scale, well-designed RCTs are needed...