Shedding light on polypragmasy of pain after transurethral prostate surgery procedures: a systematic review and meta-analysis

Wroclawski, Marcelo Langer; Castellani, Daniele; Heldwein, Flávio Lobo; Teles, Saulo Borborema; Doyun, Jonathan; Zhao, Hongda; Herrmann, Thomas; Chan, Vinson Wai‐Shun; Teoh, Jeremy Yuen‐Chun

doi:10.1007/s00345-021-03678-6

Cited by 6 publications

(4 citation statements)

References 84 publications

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“…Indeed, a recent systematic review confirmed that the incidence of postoperative dysuria/urgency after transurethral BPH surgery was significantly higher after ablation procedures as compared to enucleation techniques and TURP. 29 QoL results revealed a different trend than urinary symptoms change. Indeed, early outcomes of QoL (2 and 3-year follow-up) were similar between the two groups, although early IPSS were lower in patients treated with GLL PVP.…”

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confidence: 79%

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GreenLight Laser™ Photovaporization versus Transurethral Resection of the Prostate: A Systematic Review and Meta-Analysis

Castellani

Pirola

Rubilotta

et al. 2021

RRU

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GreenLight laser™ photovaporization of the prostate (GLL-PVP) has become a valid alternative to traditional transurethral resection of the prostate (TURP) in men requiring surgery for benign prostatic hyperplasia. We aimed to review systematically the safety and efficacy of studies comparing GLL PVP and TURP in the medium-term. A comprehensive literature search was performed. Twelve studies were identified for meta-analysis. Meta-analyses showed a longer postoperative catheterization time (risk ratio (RR): 1.12, 95% CI:1.09-1.14, p<0.00001) and length of stay (RR: 1.16, 95% CI:1.12-1.19, p<0.00001) in the TURP group; higher risk of transfusion in the TURP group (RR: 6.51, 95% CI: 2,90-14,64 p<0.00001); no difference in the risk of urinary tract infections (RR: 0.83, 95% CI: 0.58-1.18, p=0.30) and transient recatheterization (RR: 1.11, 95% CI: 0.76-1.60, p=0.60). Regarding reoperation rate, no difference was found in term of postoperative urethral stricture (RR: 1.13, 95% CI: 0.73-1.75, p=0.59) and bladder neck contracture (RR: 0.66, 95% CI: 0.31-1.40, p=0.28). A significantly higher incidence in reoperation for persistent/regrowth adenoma was present in the GLLL-PVP (RR: 0.64, 95% CI: 0.41-0.99, p=0.05). Data at 2-year follow-up showed significant better post-voiding residual (PVR) (MD: -1.

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confidence: 79%

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confidence: 99%

GreenLight Laser™ Photovaporization versus Transurethral Resection of the Prostate: A Systematic Review and Meta-Analysis

Castellani

Pirola

Rubilotta

et al. 2021

RRU

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“…Post-laser prostate enucleation irritative symptoms have been described by many studies. The pooled calculated incidence of such symptoms in a meta-analysis of eight studies reached up to 9% of patients who underwent the procedure [ 23 ]. Such symptoms, even transient in the majority of cases, may have a negative impact on the patients’ quality of life, and the management is still under debate [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Such symptoms, even transient in the majority of cases, may have a negative impact on the patients’ quality of life, and the management is still under debate [ 24 ]. A true explanation of these symptoms has not been established, but laser-induced capsular irritation along with urinary tract infections has been suggested [ 23 ]. Relatedly, in this study, the high-power group manifested much more irritative symptoms than the low-power group in the first three months, and these symptoms did not last for 6 months after the procedure.…”

Section: Discussionmentioning

confidence: 99%

A prospective analysis of thulium laser enucleation in benign prostatic hyperplasia comparing low- and high-power approaches for prostates exceeding 80 g

Abdelaziz,

Kamal,

Abdelhakim

et al. 2024

World J Urol

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Introduction and objectives To compare the perioperative and functional outcomes of low-power and high-power thulium:YAG VapoEnucleation (ThuVEP) of the prostate for the treatment of large-volume benign prostatic hyperplasia (BPH) (> 80 ml). Patients and methods A prospective analysis of 80 patients with symptomatic BPO and prostatic enlargement (more than 80 ml) was conducted. They were divided randomly into two groups (40 patients in each group). One group was treated with low-power ThuVEP, and the other group was treated with high-power ThuVEP. All patients were assessed preoperatively and early postoperatively, and 12-month follow-up data were analyzed. The complications were noted and classified according to the modified Clavien classification system. Results The mean age at surgery was 68 (± 6.1) years, and the mean prostate volume was 112 (± 20.1) cc, and there were no differences between the groups (p = 0.457). The mean operative time was 88.4 ± 11.79 min for group A and 93.4 ± 16.34 min for group B, while the mean enucleation time was 59.68 ± 7.24 min for group A and 63.13 ± 10.75 min for group B. There were no significant differences between the groups regarding catheterization time and postoperative stay. The quality of life (QoL), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoiding residual urine (PVR), and prostate volume improved significantly after treatment and were not significantly different between those treated with the different energies. The incidence of complications was low and did not differ between both the groups. Conclusion Low-power ThuVEP is feasible, safe, and effective with comparable results with high-power ThuVEP in the treatment of BPO.

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Personal deductions from the new lasers: as low as you can go (“no-touch low-power” HoLEP)

Scoffone,

Cracco

2023

World J Urol

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Shedding light on polypragmasy of pain after transurethral prostate surgery procedures: a systematic review and meta-analysis

Cited by 6 publications

References 84 publications

GreenLight Laser™ Photovaporization versus Transurethral Resection of the Prostate: A Systematic Review and Meta-Analysis

GreenLight Laser™ Photovaporization versus Transurethral Resection of the Prostate: A Systematic Review and Meta-Analysis

A prospective analysis of thulium laser enucleation in benign prostatic hyperplasia comparing low- and high-power approaches for prostates exceeding 80 g

Personal deductions from the new lasers: as low as you can go (“no-touch low-power” HoLEP)

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