Objective:The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia(BPH)treated with prostatic Aquablation.Materials and methods:We performed a litera...Objective:The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia(BPH)treated with prostatic Aquablation.Materials and methods:We performed a literature search of clinical trials using the MEDLINE,Embase,and Cochrane Library databases and retrieved published works on Aquablation for the treatment of BPH up to August 2021.Unpublished works,case reports,conference proceedings,editorial comments,and letters were excluded.Risk of bias was assessed using the ROBINS-I tool.Raw means and mean differences were meta-analyzed to produce summary estimates for pre-versus post-international Prostate Symptom Scores,maximum flow rate,and male sexual health questionnaire value changes.An inverse-variance weighted random effects model was used.Results:Seven studies were included in this review(n=551 patients)that evaluated various urological parameters.At 3 months,the International Prostate Symptom Scores raw mean difference from baseline was-16.475(95%confidence interval[CI],-15.264 to-17.686;p<0.001),with improvements sustained for 12 months.Similarly,maximum flow rate improved by+1.96(95%CI,10.015 to 11.878;p<0.001)from pre to 3 months postoperatively.In addition,the male sexual health questionnaire change pooled effect size was-0.55(95%CI,-1.621 to 0.531;p=0.321)from preintervention to postintervention at 3 months.Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias.Conclusions:Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function.Further research is required to confirm these preliminary results.展开更多
The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs)....The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male LUTS.The aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still lacking.Most of them are still under investigation and,to date,only a few options have been given as a recommendation for use.They cannot be considered as standard of care and are not suitable for all patients.Advantages and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.展开更多
基金sponsored by the Australian-America Fulbright Commission administered through a 2021-2022 Fulbright Future Scholarship funded by the Kinghorn Foundation.
文摘Objective:The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia(BPH)treated with prostatic Aquablation.Materials and methods:We performed a literature search of clinical trials using the MEDLINE,Embase,and Cochrane Library databases and retrieved published works on Aquablation for the treatment of BPH up to August 2021.Unpublished works,case reports,conference proceedings,editorial comments,and letters were excluded.Risk of bias was assessed using the ROBINS-I tool.Raw means and mean differences were meta-analyzed to produce summary estimates for pre-versus post-international Prostate Symptom Scores,maximum flow rate,and male sexual health questionnaire value changes.An inverse-variance weighted random effects model was used.Results:Seven studies were included in this review(n=551 patients)that evaluated various urological parameters.At 3 months,the International Prostate Symptom Scores raw mean difference from baseline was-16.475(95%confidence interval[CI],-15.264 to-17.686;p<0.001),with improvements sustained for 12 months.Similarly,maximum flow rate improved by+1.96(95%CI,10.015 to 11.878;p<0.001)from pre to 3 months postoperatively.In addition,the male sexual health questionnaire change pooled effect size was-0.55(95%CI,-1.621 to 0.531;p=0.321)from preintervention to postintervention at 3 months.Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias.Conclusions:Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function.Further research is required to confirm these preliminary results.
文摘The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male LUTS.The aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still lacking.Most of them are still under investigation and,to date,only a few options have been given as a recommendation for use.They cannot be considered as standard of care and are not suitable for all patients.Advantages and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.
