Castellani Daniele, Rubilotta Emanuele, Fabiani Andrea, Maggi Martina, Wroclawski Marcelo Langer, Teoh Jeremy Yuen-Chun, Pirola Giacomo Maria, Gubbiotti Marilena, Pavia Maria Pia, Gomez-Sancha Fernando, Galosi Andrea Benedetto, Gauhar Vineet
Faculty of Medicine, School of Urology, Università Politecnica delle Marche, Ancona, Italy.
Department of Urology, Azienda Ospedaliero Universitaria of Verona, University of Verona, Verona, Italy.
J Endourol. 2022 Oct;36(10):1331-1347. doi: 10.1089/end.2022.0222. Epub 2022 Jun 13.
To perform a systematic review to assess the incidence of transient (<6 months) and persistent (>6 months) stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) after transurethral surgeries for benign prostatic hyperplasia. A systematic literature search was performed using Embase, PubMed, and Web of Science. We included studies comparing monopolar (M)/bipolar (B) transurethral resection of the prostate (TURP) ablation enucleation procedures. Incidence of incontinence was assessed using Cochran-Mantel-Haenszel Method and reported as odds ratio (OR), 95% confidence interval (CI), and -values. Statistical significance was set at < 0.05 Twenty-eight studies were included. Incidence of transient SUI was 4.6%, 6.0%, 3.0%, and 2.4% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent SUI was 1.1% after ablation, 1.7% after enucleation and M-TURP, and 1.0% after B-TURP. Incidence of transient UUI was 2.0%, 7.3%, 4.4%, and 2.8% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent UUI was 2.2% after M-TURP. The incidence of transient MUI was 5.1%, 0.8%, 5.4%, and 0.9% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent MUI was 3.1% after ablation and 4.8% after M-TURP. Incidence of transient and persistent SUI and UUI did not differ after TURP enucleation. Incidence of transient (OR 3.32, 95% CI 0.41-26.65, = 0.26) and persistent SUI (OR 4.79, 95% CI 0.52-43.89, = 0.17) was not significantly higher after ablation. Incidence of transient UUI was not significantly higher after ablation (OR 2.62, 95% CI 0.04-166.01, = 0.65), whereas persistent UUI did not differ. Incidence of transient MUI was significantly higher after enucleation (OR 3.26, 95% CI 1.51-7.05, = 0.003). Incidence of transient and persistent MUI did not differ after TURP ablation. Ablation, enucleation, and TURP have an impact on all forms of incontinence, but this is transient in most cases with no difference between the groups, except for MUI, which was higher after enucleation M-TURP.
进行一项系统评价，以评估经尿道前列腺增生手术治疗后短暂性（<6个月）和持续性（>6个月）压力性尿失禁（SUI）、急迫性尿失禁（UUI）及混合性尿失禁（MUI）的发生率。使用Embase、PubMed和Web of Science进行系统的文献检索。我们纳入了比较单极（M）/双极（B）经尿道前列腺切除术（TURP）、消融术、剜除术的研究。使用 Cochr an - Mantel - Haenszel方法评估尿失禁的发生率，并报告为比值比（OR）、95%置信区间（CI）和P值。设定统计学显著性为P < 0.05。共纳入28项研究。消融术、剜除术、M - TURP和B - TURP后短暂性SUI的发生率分别为4.6%、6.0%、3.0%和2.4%。消融术后持续性SUI的发生率为1.1%，剜除术和M - TURP后为1.7%，B - TURP后为1.0%。消融术、剜除术、M - TURP和B - TURP后短暂性UUI的发生率分别为2.0%、7.3%、4.4%和2.8%。M - TURP后持续性UUI的发生率为2.2%。消融术、剜除术、M - TURP和B - TURP后短暂性MUI的发生率分别为5.1%、0.8%、5.4%和0.9%。消融术后持续性MUI的发生率为3.1%，M - TURP后为4.8%。TURP和剜除术后短暂性和持续性SUI及UUI的发生率无差异。消融术后短暂性（OR 3.32，95% CI 0.41 - 26.65，P = 0.26）和持续性SUI（OR 4.79，95% CI 0.52 - 43.89，P = 0.17）的发生率无显著升高。消融术后短暂性UUI的发生率无显著升高（OR 2.62，95% CI 0.04 - 166.01，P = 0.65），而持续性UUI无差异。剜除术后短暂性MUI的发生率显著升高（OR 3.26，95% CI 1.51 - 7.05，P = 0.003）。TURP和消融术后短暂性和持续性MUI的发生率无差异。消融术、剜除术和TURP对所有形式的尿失禁均有影响，但在大多数情况下是短暂的，各组之间无差异，除了MUI在剜除术和M - TURP后较高。
