| Objective: This study intends to compare the safety and efficacy of PKEP and PKRP in the treatment of BPH by meta-extractive analysis,providing theoretical basis for patients with BPH to choose a more appropriate surgical treatment.Methods: This Meta analysis searched the domestic and foreign databases such as Cochrane Library,Pub Med,Embase,Sinomed,CNKI,Wan Fang,VIP,etc.,to collect the related literature published from the establishment of the database to January 16,2021.In addition,it compared the safety and efficacy of PKEP and PKRP in the treatment of BPH.Two evaluators independently carried out literature screening,literature quality evaluation,data extraction and data analysis without reference or discussion.The thirdparty evaluator would evaluate it and finally reach a consensus if the result was controversial.The special Meta analysis software Rev Man5.4 provided by Cochrane assistance network was adopted to evaluate the literature quality and to integrate and analyze the data of the included documents.Results:A total of 1411 Chinese and English articles were screened,and 22 articles were included in this study,a total of 2243 patients,all of which were RCT(including 3 English articles and 19 Chinese articles).The results of Meta analysis showed that: 1 effectiveness: one month after operation: one month after operation,IPSS,Qo L,Qmax and RUV in PKEP group were slightly better than those in PKRP group,but the difference was not statistically significant.Three months after operation,IPSS and Qmax in the PKEP group were significantly better than those in the PKRP group,and the difference was statistically significant.The RUV and Qo L in the PKEP group were slightly better than those in the PKRP group 3 months after operation,but the difference was not statistically significant.Six months after operation,IPSS,Qo L,Qmax and RUV in the PKEP group were better than those in the PKRP group,and the difference was statistically significant.12 months after operation:IPSS,Qo L and Qmax in the PKEP group were better than those in the PKRP group,and the difference was not statistically significant.The tissue mass of prostatectomy in PKEP group was much higher than that in PKRP group,and the difference was statistically significant.In terms of safety,the amount of intraoperative bleeding,the operation time,the time of indwelling catheter,the postoperative hospital stay,the postoperative bladder irrigation time,in the PKEP group were better than those in the PKRP group,and the difference was statistically significant.Complications: The incidence of postoperative transient urinary incontinence in PKEP group and PKRP group was roughly the same,and the difference was not statistically significant.The probability of secondary hemorrhage after operation in PKEP group was significantly lower than that in PKRP group,and the difference was statistically significant.The probability of postoperative urethral stricture in PKEP group was significantly lower than that in PKRP group,and the difference was statistically significant.The probability of retrograde ejaculation in PKEP group and PKRP group was basically the same,but the difference was not statistically significant.The probability of capsule perforation in PKEP group was significantly lower than that in PKRP group,and the difference was statistically significant.Conclusion: It can be concluded that the medium-term curative effect of PKEP is significantly better than that of PKRP group(3 and 6 months after operation),and the short-term(1 month after operation)and long-term effect(12 months after operation)is similar to that of PKRP group.Besides,the safety and postoperative complications of PKRP group are significantly better than those of PKRP group. |
