Simulateneously Transurethral Resection Of Non-muscle Invasive Bladder Cancer And Benign Prostatic Hyperplasia:a Systematic Review And Meta-analysis

Objective: To systematic review: the therapeutic effect and security of simultaneous surgery(transurethral resection of the bladder tumor and transurethral resection of the prostate)compared with non-simultaneous surgery(transurethral resection of the bladder tumor only)for non-muscle invasive bladder tumor and benign prostatic hyperplasia;the impact of laser versus electroresection in simultaneous surgery.Methods: Literature research was conducted in the database: Embase?Pubmed?Cochrane Library?CNKI?WanfangData?CBM?VIP to get the clinical control trials(Randomized controlled trial and Retrospective cohort study)of simulateneous transurethral resection for NMIBC with BPH to 2018.01.Two reviewers conducted independent literature screening,data extraction and document quality scoring.Data is synthesized and analyzed by Revman 5.3Results: We included 22 trials with 1995 patients in this analysis.Meta analysis shows,simultaneous surgery group compared with non-simultaneous surgery group : the tumor recurrence rate is lower [OR=0.66 95%CI(0.54,0.82),P=0.0002];urethral stricture rate is lower[OR=0.27 95%CI(0.13,0.54),P=0.0002];The difference of prostate fossa or posterior urethral implantation and tumor recurrence time is not statistically significant.Simultaneous surgery with laser group compared with electroresection group,the tumor recurrence rate is lower [OR=0.2 95%CI(0.07,0.62),P=0.005];intraoperative bleeding is less [MD=-50.3 95%CI(-55.28,-45.51),P=0.0009];the incidence of intraoperative complications is lower[OR=0.09 95%CI(0.02,0.48),P=0.005],The mitigation effect of postoperative urinary tract obstruction was no significant difference between the two groups(P>0.05)?Conclusion: Simultaneous surgery group compared with non-simultaneous surgery group for NMIBC with BPH:tumor recurrence rate or the incidence of urethral stricture is lower;the incidence of tumor implantation in prostate fossa and posterior urethral or tumor recurrence time between the two groups is not statistically significant.Simultaneous surgery with laser grow compared with electroresection: tumor recurrence rate and the incidence of intraoperative complications is lower;intraoperative bleeding is less;the mitigation effect of postoperative urinary tract obstruction was no significant difference between the two groups.