Chen David C, Qu Liang, Webb Howard, Qin Kirby, Chislett Bodie, Xue Alan, Khaleel Sari, De Jesus Escano Manuel, Chung Eric, Adam Ahmed, Bolton Damien, Perera Marlon
Department of Surgery, University of Melbourne, Austin Health, Melbourne, Australia.
Young Urology Researchers Organisation (YURO), Melbourne, Australia.
Curr Urol. 2023 Mar;17(1):68-76. doi: 10.1097/CU9.0000000000000122. Epub 2022 Aug 31.
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.
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 Unpublished works, case reports, conference proceedings, editorial comments, and letters were excluded.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.
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; < 0.001), with improvements sustained for 12 months. Similarly, maximum flow rate improved by +1.96 (95% CI, 10.015 to 11.878; < 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; 0.321) from preintervention to postintervention at 3 months. Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias.
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.
本研究旨在调查接受前列腺水消融术治疗的良性前列腺增生（BPH）男性患者下尿路症状的改善情况。
我们使用MEDLINE、Embase和Cochrane图书馆数据库对临床试验进行了文献检索，并检索了截至2021年8月发表的关于水消融术治疗BPH的研究。未发表的作品、病例报告、会议记录、编辑评论和信件均被排除。使用ROBINS-I工具评估偏倚风险。对原始均值和均值差异进行荟萃分析，以得出国际前列腺症状评分、最大尿流率和男性性健康问卷值术前与术后变化的汇总估计值。采用逆方差加权随机效应模型。
本综述纳入了7项研究（n = 551例患者），这些研究评估了各种泌尿外科参数。在3个月时，国际前列腺症状评分与基线的原始均值差异为-16.475（95%置信区间[CI]，-15.264至-17.686；P < 0.001），改善情况持续了12个月。同样，术后3个月最大尿流率较术前提高了+1.96（95% CI，10.015至11.878；P < 0.001）。此外，在3个月时，从干预前到干预后，男性性健康问卷变化的合并效应大小为-0.55（95% CI，-1.621至0.531；P = 0.321）。对一些结果的荟萃分析显示存在较大的统计异质性或发表偏倚的证据。
水消融术似乎可改善BPH男性患者的下尿路症状，同时相对保留性功能。需要进一步研究来证实这些初步结果。
