BackgroundTo compare the clinical efficiency and safety of transurethral resection of the prostate (TURP) and prostatic artery embolization (PAE) for the treatment of Benign prostatic hyperplasia (BPH).MethodsWe searched PUBMED, EMBASE and the Cochrane Central Register for studies from May 1998 to May 2018 for studies comparing the efficiency and safety of TURP with PAE. Four studies met the inclusion criteria for our meta-analysis. After data extraction and quality assessment, we used RevMan 5.2 to pool the data.ResultsA total of four studies involving 506 patients were included in our meta-analysis. The pooled data showed that the Qmax was higher in TURP group than PAE with a significant difference (WMD:4.66, 95%CI 2.54 to 6.79, P < 0.05). The postoperative QOL was lower in the TURP than PAE group (WMD: -0.53, 95%CI -0.88 to − 0.18, P < 0.05). The postoperative prostate volume was significantly smaller in the TURP than PAE group (WMD: -8.26, 95%CI -12.64 to − 3.88, P < 0.05). The operative time was significantly shorter in the TURP than PAE group (WMD: -10.55, 95%CI -16.92 to − 4.18, P < 0.05). No significant difference was found in the postoperative IPSS and complications between TURP and PAE (P > 0.05, WMD:1.56, 95%CI -0.67 to 3.78, p = 0,05, OR:1.54, 95%CI 1.00 to2.38, respectively).ConclusionsTURP could achieve improved Qmax and QoL compared to PAE. Therefore, for patients with BPH and lower urinary tract symptoms (LUTS), TURP was superior to PAE.

Background: To compare the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy with those of retroperitoneal laparoscopic adrenalectomy for patients with pheochromocytoma. Methods: We searched PubMed, EMBASE and the Cochrane Central Register for studies from 1999 to 2019 to assess the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy and the retroperitoneal approach for laparoscopic adrenalectomy in patients with pheochromocytoma. After data extraction and quality assessments, we used RevMan 5.2 to pool the data. Results: Four retrospective studies were obtained in our meta-analysis. Patients who underwent retroperitoneal laparoscopic adrenalectomy were associated with shorter operative time (WMD: 34.91, 95% CI: 27.02 to 42.80, I2 = 15%; p < 0.01), less intraoperative blood loss (WMD: 139.32, 95% CI: 125.38 to 153.26, I2 = 0, p < 0.01), and a shorter hospital stay (WMD: 2, 95% CI: 1.18 to 2.82, I2 = 82%, p < 0.01) than patients who underwent transperitoneal laparoscopic adrenalectomy. No significant differences were found in the complication rate (OR: 1.58, 95% CI: 0.58 to 4.33, I 2 = 0; p = 0.38) or in the incidence of hemodynamic crisis (OR: 0.74, 95% CI: 0.19 to 2.94, p = 0.67) between the two groups. Conclusion: Retroperitoneal laparoscopic adrenalectomy could achieve better perioperative outcomes than the transperitoneal approach for patients with pheochromocytoma.

Background The efficacy of partial nephrectomy (PN) for T1b renal cell carcinoma (RCC) is controversial. The oncological outcomes, the change in postoperative renal function and the perioperative complications are unclear. Methods We searched PUBMED, EMBASE and the Cochrane Central Register for studies from March 1998 to March 2018 for studies comparing PN to radical nephrectomy (RN) for the treatment of T1b RCC. After data extraction and quality assessment, we used RevMan 5.2 to pool the data. Then, we used Stata 12.0 to perform sensitivity analyses and meta-regression. We used the GRADE profiler to evaluate the evidence according to the GRADE approach. Results A total of 16 studies involving 33,117 patients were included in our meta-analysis. No significant difference was found in the 5-year overall survival (OS), 10-year OS, 5-year recurrence-free survival (RFS) and 10-year RFS. The 5-year cancer-special survival (CSS) and 10-year CSS were better in RN compared to PN, respectively, at RR = 1.02, P < 0.05 and RR = 1.04, P < 0.05. PN was better than RN in the preservation of renal function (WMD = -9.15, 95% CI: − 10.30 to − 7.99, P < 0.05). The confidence level grading of the evidence was moderate for 5-year OS, 10-year OS, 5-year CSS, 10-year CSS, 5-year RFS, 10-year RFS, tumor recurrence, decline in eGFR, and postoperative complications. Conclusions PN may provide comparable outcomes in terms of RFS & OS, and better renal function preservation although CSS was worse. Electronic supplementary material The online version of this article (10.1186/s12894-019-0480-6) contains supplementary material, which is available to authorized users.

Background The relation between bariatric surgery and semen parameters and reproductive hormones on obese male remains incompletely understood.Methods We searched PUBMED, EMBASE and the Cochrane Central Register for studies from 1999 to 2019 for studies on effect of bariatric surgery on obese male semen parameters and reproductive hormones. Three studies met the inclusion criteria for our meta-analysis. After data extraction and quality assessment, we used RevMan 5.2 to pool the data.Results Three studies were included in our meta-analysis. The pooled data showed that the testosterone concentration and sperm volume were higher in postoperative group than baseline with a significant difference (WMD:4.63, 95%CI 2.65 to 6.61, P<0.05, WMD; 0.89, 95CI 0.38 to 1.40, P<0.05, respectively). No significant difference was found in the postoperative sperm concentration, sperm morphology, sperm motility and estradiol concentration (WMD: -3.28, 95%CI: -38.86 to 32.29, I2=9%; p=0.89,WMD: -0.52, 95%CI: -5.83 to 4.79, I2=71%; p=0.85, (WMD; -0.01, 95%CI; -5.42 to 5.40, I2=0; p=1.00, WMD: -2.93, 95%CI: -43.11 to 37.24, I2=87%; p=0.89, respectively).Conclusions Bariatric surgery did not interfere with sperm quality. Our study showed that the postoperation testosterone increased with statistically significance.

Background To perform a meta-analysis of comparative studies reporting oncological and renal function outcomes of of partial ureterectomy and radical nephroureterectomy in upper tract urothelial carcinoma (UTCC). Methods A literature search of PubMed, Embase, and the Cochrane library was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and a meta-analysis was performed to assess cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), and perioperative variations in the estimated glomerular filtration rate (eGFR). Results Nineteen studies involving 4940 patients were included in our meta-analysis. No significant differences were found in the 5-year OS (HR=1.20, p=0.40), 5-year RFS (HR=1.21, p=0.37) and CSS (HR=0.89, p=0.20). A better preservation of renal function of PU compared with RNU changes in (eGFR) (WMD=-9.75, p=0.0006) between the patients undergoing the two types of surgery. Conclusions PU could achieve equal oncological outcomes and better postoperative renal function than RNU.

Background: To assess the effectiveness and safety of retrograde intrarenal surgery(RIRS) and percutaneous nephrolithotomy(PCNL) as surgical management strategies for solitary kidney calculi. Methods: Our team searched the PubMed, Cochrane and Web of Science databases up to February 28, 2019, for relevant published studies. After data extraction and quality assessment, Review Manager 5.3.5.0 software was used to pool the data. Results: Four studies involving 314 patients were included in our meta-analysis. The pooled data showed that the stone-free rate(SFR) was higher in the PCNL group than in the RIRS group, and the difference was significant(OR:0.36, 95% CI: 0.20 to 0.67, P =0.001). No significant differences were found in minor complications or major complications between the RIRS and PCNL groups(P > 0.05, OR:0.79, 95% CI: 0.46 to 1.35;p > 0.05, OR:2.96, 95% CI: 0.67 to 12.96, respectively). Conclusions: Neither the minor nor the major complications of RIRS and PCNL showed any statistical differences. Additionally, PCNL provided a higher SFR than RIRS. There exists enormous heterogeneity in mean operation time. Overall, this meta-analysis may help urologists make decisions regarding interventions for solitary kidney calculi management. Keywords: Solitary kidney, Calculi, Retrograde Intrarenal surgery, Percutaneous Nephrolithotomy, Meta-analysis