New Ultra-minimally Invasive Surgical Treatment for Benign Prostatic Hyperplasia: A Systematic Review and Analysis of Comparative Outcomes

Checcucci, Enrico; Veccia, Alessandro; Cillis, Sabrina De; Piramide, Federico; Volpi, G.; Amparore, Daniele; Pecoraro, Angela; Piana, Alberto; Granato, Stefano; Verri, Paolo; Sica, Michele; Mézière, Juliette; Carbonaro, Beatrice; Piscitello, Stefano; Zamengo, Davide; Cacciamani, Giovanni; Okhunov, Zhamshid; Puliatti, Stefano; Taratkin, Mark; Marenco, José Luis; Rivas, Juan Gómez; Veneziano, Domenico; Carbonara, Umberto; Russo, Giorgio Ivan; Luca, Stefano De; Manfredi, Matteo; Fiori, Cristian; Autorino, Riccardo; Porpiglia, Francesco

doi:10.1016/j.euros.2021.08.009

Cited by 46 publications

(34 citation statements)

References 80 publications

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“…Previous meta-analyses investigated the topic [184][185][186][187][188], with partially contradictory data. Different results between these and with respect to our article could be justified by heterogeneous study selection criteria resulting in the inclusion of different papers, as well as the publication of new articles that could be included in the analysis over the years.…”

Section: Discussion Of Resultsmentioning

confidence: 99%

“…Finally, plasmakinetic resection of the prostate, holmium laser resection of the prostate, open simple prostatectomy (OP), and laparoscopic simple prostatectomy (LSP) had no impact on IIEF-5 scores. Checcucci et al [185] investigated 48 papers (35 single-arm studies, 12 RCTs, and one comparative study) including a total of 2689 patients undergoing Rezum, PUL, PAE, temporarily implanted nitinol device, or intraprostatic injections. No analysis of posttreatment changes in IIEF-5 score was possible due to the lack of data.…”

Section: Discussion Of Resultsmentioning

confidence: 99%

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Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Manfredi¹,

García‐Gómez²,

Arcaniolo³

et al. 2022

European Urology Focus

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Section: Discussion Of Resultsmentioning

confidence: 99%

Section: Discussion Of Resultsmentioning

confidence: 99%

Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Manfredi¹,

García‐Gómez²,

Arcaniolo³

et al. 2022

European Urology Focus

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“…Prior to treatment, PVol was 66 ml (IQR 48-67), Q max 13.5 ml/s (IRQ 11. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], IPSS 23 (IQR 18-25), and QoL 4.5 (IQR 4-5).…”

Section: Resultsmentioning

confidence: 99%

“…The temporary implantable nitinol device is a "micro-invasive" option that showed an encouraging rate of ejaculation preservation (6). Recent systematic reviews evaluated the effects on ejaculatory dysfunction of many other "microinvasive" or "ultra minimally-invasive" treatment modalities to manage BPO: water vapor thermal therapy, prostatic urethral lift, waterjet ablation, and prostatic arterial embolization (PAE) showed less than 2% rate of retrograde ejaculation at 1-year follow-up (7,8).…”

Section: Introductionmentioning

confidence: 99%

Prostatic arterial embolization as a micro-invasive treatment option for benign prostatic obstruction: A subtle balance between short-term follow-up patient-reported outcomes and de-obstructive effectiveness

et al. 2022

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PurposeThe study evaluated the effectiveness of prostatic arterial embolization (PAE) in the relief of benign prostatic obstruction (BPO) beyond the patient-reported outcomes.MethodsRetrospective evaluation of patients who underwent PAE (March 2015–December 2019). All patients underwent prostate MRI to assess prostate volume (PVol), uroflowmetry to assess Qmax, and were administered IPSS + QoL. MRI, and IPSS were repeated 3 months postoperatively. Patients were contacted for urological consultation, including uroflowmetry with post-voiding residual volume (PVR), IPSS + QoL. Additionally, patient satisfaction was assessed. Sexual function, including ejaculation and complications, was recorded.ResultsFifty-two patients were analyzed. At baseline, PVol was 66 ml (IQR 48–67), Qmax 13.5 ml/s (IRQ 11.5–19), IPSS 23 (IQR 18–25), and QoL 4.5 (IQR 4–5). At 3-month follow-up, MRI showed a 27% (IQR 18–36) reduction in PVol (p <0.001). The IPSS decreased by 81% (IQR 58–91, p <0.001). At a median follow-up of 14 months (IQR 10.5–27.5), IPSS decreased by 40% (IQR 26–54, p <0.001) and QoL by 50% (IQR 20–75, p = 0.002) versus baseline. The absolute Qmax was 12.2 ml/s (IQR 9.5–14). Median %variation of Qmax vs baseline was −7.3% (IQR −33.9; +25.5, p = 0.7). All sexually active patients maintained ejaculation. Thirty-eight (73%) were satisfied with the treatment they received. One patient reported post-operative erectile dysfunction. All patients who were counseled for adjuvant endoscopic treatment refused surgery except for one.ConclusionIn our analysis, PAE provided significant improvement in the short-term follow-up patient-reported outcomes. Most patients were satisfied, and ejaculation was maintained. On the other hand, the effectiveness of PAE on the relief of BPO seemed virtually intangible in most of the cases.

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“…Of note, in the last 5 years, several ultra-minimally invasive surgical techniques (uMISTs) have been added to the armamentarium of the urologist to personalize treatment of patients with LUTS due to BPO (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Transperineal laser ablation of the prostate with EchoLaser™ system: perioperative and short-term functional and sexual outcomes

et al. 2022

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ObjectiveTo date, several ultra-minimally-invasive surgical techniques are available for the treatment of male LUTS due to benign prostatic obstruction (BPO). Herein we report our preliminary experience with SoracteLite™ TPLA for the treatment of carefully selected patients with LUTS due to BPO.MethodsData from all consecutive patients undergoing TPLA at our institution between April 2021 and February 2022 were prospectively collected in a specific database. Data regarding functional and sexual outcomes evaluated by validated questionnaires and uroflowmetry were analyzed. All the procedure were performed in an outpatient setting, under local anesthesia and conscious sedation, using EchoLaser device, a multisource diode laser generator.ResultsOverall, 38 patients underwent TPLA at our institution during the study period. The median prostate volume was 46 ml (IQR 38-71). The median time to complete the procedure was 31 min (IQR 28-37). All patients but one were discharged within 8 hours of hospital stay. No perioperative Clavien-Dindo grade ≥2 complications were recorded. Median improvement in Qmax was 17%, 24% and 32% at 1 month, 3 months and last follow-up after surgery; as a result, the median postoperative IPSS at 1 month, 3 months and at last follow-up decreased by -14%, -36% and -35%, respectively. All patients preserved ejaculatory and sexual function. Two patients (5%), catheter carriers before the procedure, experienced acute urinary retention after TPLA treatment and required replacement of an indwelling catheter.ConclusionsTPLA can be a feasible, safe and effective ultra-minimally-invasive procedure for carefully selected patients with LUTS due to BPO.

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New Ultra-minimally Invasive Surgical Treatment for Benign Prostatic Hyperplasia: A Systematic Review and Analysis of Comparative Outcomes

Cited by 46 publications

References 80 publications

Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Prostatic arterial embolization as a micro-invasive treatment option for benign prostatic obstruction: A subtle balance between short-term follow-up patient-reported outcomes and de-obstructive effectiveness

Transperineal laser ablation of the prostate with EchoLaser™ system: perioperative and short-term functional and sexual outcomes

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