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‘Button type’ bipolar plasma vaporisation of the prostate compared with standard transurethral resection: a systematic review and meta‐analysis of short‐term outcome studies
Author(s) -
Wroclawski Marcelo L.,
Carneiro Arie,
Amarante Rodrigo Dal Moro,
Oliveira Carlos E.B.,
Shimanoe Victor,
Bianco Bianca A.V.,
Sakuramoto Paulo K.,
Pompeo Antonio C.L.
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13255
Subject(s) - medicine , meta analysis , transurethral resection of the prostate , confidence interval , odds ratio , prostate , urology , international prostate symptom score , hyperplasia , surgery , lower urinary tract symptoms , cancer
Objective To evaluate the surgical morbidity and effectiveness in improving symptoms of benign prostatic hyperplasia ( BPH ), comparing ‘button‐type’ bipolar plasma vaporisation ( BTPV ) vs transurethral resection of the prostate ( TURP ). Methods We conducted a literature search of published articles until November 2014. Only prospective and randomised studies with comparative data between BTPV and conventional TURP (mono‐ or bipolar) were included in this review. Results Six articles were selected for the analyses. In the 871 patients evaluated, 522 underwent TURP and 349 BTPV . There was a tendency for a higher transfusion rate in the TURP group, with two BTPV cases (0.006%) and 16 TURP cases (0.032%) requiring transfusions ( P = 0.06). The number of complications was similar between the groups (odds ratio 0.33, 95% confidence interval [ CI ] 0.8–1.31; P = 0.12; I 2 = 86%). When subdivided by severity, 10.7% (14/131) and 14.6% (52/355) of complications were classified as severe (Clavien 3 or 4) in patients who underwent BTPV and TURP , respectively ( P = 0.02). The average duration of indwelling catheterisation was significantly less in patients who underwent BTPV (standardised mean difference [ SMD ] −0.84; 95% CI −1.54 to 0.14; P = 0.02; I 2 = 81%). Both treatments significantly improved symptoms and the postoperative International Prostate Symptom Score was similar in both groups ( SMD 0.09, 95% CI −1.56 to 1.73; P = 0.92). Conclusion BTPV is an effective and safe treatment for BPH . The improvement of urinary symptoms and overall complications are comparable to conventional TURP . However, BTVP appears to be associated with a lower rate of major complications and duration of indwelling catheterisation.