A Systematic Review and Meta-analysis of Prostatic Urethral Lift for Male Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.
A Systematic Review and Meta-analysis of Prostatic Urethral Lift for Male Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.
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前列腺尿道提升术治疗良性前列腺增生继发的男性下尿路症状的系统回顾和荟萃分析
DOI：
10.1016/j.euros.2020.05.001
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发表时间：
2020-07
影响因子：
2.5
通讯作者：
Ping H
中科院分区：
文献类型：
--
作者：
Xiang P;Wang M;Guan D;Liu D;Wang Y;Hao Y;Li S;Liu Y;Ping H
最近，前列腺尿道提升术（PUL）被用于治疗继发于良性前列腺增生（BPH）的下尿路症状（LUTS）。虽然PUL的初步临床研究正在增加，但该手术的长期有效性和安全性仍然没有得到很好的评价。我们的研究目的是综合现有的文献证据，对PUL手术进行全面和长期的系统评价。对电子数据库（包括PubMed、Embase和奥维德）进行了系统检索。检索期截至2020年1月1日。根据特定的纳入和排除标准，收集了关于PUL的全面回顾性和前瞻性研究。采用固定或随机效应模型计算合并前列腺症状评分、性健康评分和功能结局。19篇文章符合我们确定的纳入和排除标准，11个独立的患者系列被纳入最终分析。荟萃分析结果表明，PUL手术后患者的改善，包括国际前列腺症状评分改善9.73-12.16分，BPH影响指数改善3.74-4.50分，最大流速改善3.44-4.26 ml/s，生活质量改善2.20-2.55分。在大多数时间间隔的排尿后残气量没有显著变化。在24个月的随访期间，关于性功能的数据保持稳定或略有改善。除性功能外，合并估计值在很大程度上是异质的。PUL可持续缓解前列腺症状24个月，无严重并发症。PUL手术的一个非常重要的优点是它可以保留或稍微改善性功能。仍需要更长期和更全面的临床试验来进一步阐明PUL的功能结局和成本效益。前列腺尿道提升术是一个有吸引力的选择，为选定的患者谁寻求快速和持久的缓解下尿路症状，完全保留性功能。前列腺尿道提升术（PUL）是一种有吸引力的选择，为选定的患者寻求快速和持久的缓解下尿路症状，完全保留性功能。仍需要更长期和更多的比较性临床试验来阐明PUL的功能结局和成本效益。
Recently, prostatic urethral lift (PUL) is being used to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Although preliminary clinical studies on PUL are increasing, the long-term efficacy and safety of this procedure are still not well evaluated. The objective of our study is to synthesize the existing literature evidence, and make a comprehensive and long-term systematic review for the PUL procedure. A systematic search was performed from the electronic databases including PubMed, Embase, and OVID. The search period was up to January 1, 2020. Comprehensive retrospective and prospective studies on PUL were collected in accordance with specific inclusion and exclusion criteria. Pooled prostatic symptom scores, sexual health scores, and functional outcomes were calculated by using a fixed or random-effect model. Nineteen articles meet our determined inclusion and exclusion criteria, and 11 independent patient series were included in the final analysis. Meta-analysis results indicated improvement after the PUL procedure, including International Prostate Symptom Score improvement of 9.73–12.16 points, BPH Impact Index improvement of 3.74–4.50 points, maximum flow rate improvement of 3.44–4.26 ml/s, and quality of life improvement of 2.20–2.55 points. Postvoid residual volume at most of the intervals was not significantly variable. Data regarding sexual function remained stable or improved slightly during the 24-mo follow-up period. Pooled estimates were largely heterogeneous except for sexual function. PUL can continue to relieve prostatic symptoms for 24 mo without causing serious complications. The extremely important advantage of the PUL procedure is that it can preserve or slightly improve sexual function. Longer-term and more comprehensive clinical trials are still needed to further clarify the functional outcomes and cost effectiveness of PUL. Prostatic urethral lift is an attractive option for selected patients who seek rapid and durable relief of lower urinary tract symptoms with complete preservation of sexual function. Prostatic urethral lift (PUL) is an attractive option for selected patients who seek rapid and durable relief of lower urinary tract symptoms with complete preservation of sexual function. Longer-term and more comparative clinical trials are still needed to clarify the functional outcomes and cost effectiveness of PUL.
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影响因子：
23.4
作者：
Gratzke, Christian;Bachmann, Alexander;Gravas, Stavros
通讯作者：
Gravas, Stavros
影响因子：
3.5
作者：
McVary, Kevin T.;Gange, Steven N.;Roehrborn, Claus G.
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作者：
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作者：
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通讯作者：
McVary, Kevin T.