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Transurethral electrovaporization vs transurethral resection for symptomatic prostatic obstruction: a meta‐analysis
Author(s) -
Poulakis Vassilis,
Dahm Philipp,
Witzsch Ulrich,
Sutton Alex J.,
Becht Eduard
Publication year - 2004
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/j.1464-410x.2004.04907.x
Subject(s) - medicine , transurethral resection of the prostate , randomized controlled trial , prostate , meta analysis , urinary catheterization , urology , bladder outlet obstruction , urinary retention , urinary system , surgery , cancer
OBJECTIVE To compare the effectiveness and safety of transurethral electrovaporization (TUEVP) and transurethral resection of the prostate (TURP) for symptomatic bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH). METHODS Publications comparing TUEVP and TURP were identified systematically using Medline, the Cochrane Controlled Trial Register and other database search engines. From a total of 25 randomized controlled trials, 20 studies met the predefined inclusion criteria and were subjected to a formal meta‐analysis. Primary endpoints were symptom scores and peak urinary flow rates. Secondary endpoints included transfusion requirements, operative time, duration of catheterization, incidence of adverse events, hospital stay, re‐operation rates and sexual dysfunction. RESULTS After 1 year of follow‐up there was no significant difference between TUEVP and TURP in urinary symptom scores and peak urinary flow rates. There was heterogeneity at baseline for both primary outcome measures. TUEVP was associated with significantly lower transfusion requirements, a shorter catheterization time, and a shorter length of stay. TURP was associated with a lower risk of urinary retention afterward and re‐operation than was TUEVP. CONCLUSION This formal meta‐analysis suggests that both TUEVP and TURP in patients with symptomatic bladder outlet obstruction provide comparable improvements in maximum urinary flow rates and symptom scores. While comparative analysis is limited by the methodological shortcomings of the underlying studies and the short follow‐up, both TURP and TUEVP may offer distinct advantages in terms of secondary outcomes. A future, well‐designed, multicentre randomized clinical trial with extended follow‐up may be needed to better define the role of vaporization techniques in treating patients with symptomatic BPH.