Esmaeili Sina, Razaghi Hannaneh, Malekshahi Mahda, Soleimani Mohammad, Shafiei Seyyed Hossein, Golbakhsh Mohammadreza
Orthopaedic Subspecialty Research Centre (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arthroplast Today. 2024 Nov 5;30:101552. doi: 10.1016/j.artd.2024.101552. eCollection 2024 Dec.
Total joint arthroplasty (TJA) is one of the most frequently performed surgical procedures each year, offering considerable cost-effectiveness and numerous benefits. However, certain postoperative complications can be observed following TJA. While the relationship between various comorbidities and these complications has been well-documented, this study aims to specifically investigate the impact of benign prostatic hyperplasia (BPH) on postoperative outcomes.
For this systematic review, we searched PubMed, Scopus, and Web of Science using terms like "total hip arthroplasty," "total knee arthroplasty," "BPH," and "benign prostatic hypertrophy." Screening of retrieved articles was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing complications in TJA between patients with and without preexisting BPH were eligible for inclusion. Data extraction was performed on the included articles, and their quality was assessed using the Newcastle-Ottawa scale. A meta-analysis was conducted using the Mantel-Haenszel method.
This systematic review encompassed 4 articles evaluating TJA outcomes in men with a history of BPH, involving a total of 75,222 male cases. Among these, 17,183 cases (23%) presented with symptomatic BPH. The meta-analysis revealed that the incidence rate of periprosthetic joint infection did not significantly differ between BPH and non-BPH groups across both total hip and knee arthroplasty cases (odds ratio [OR] (95% confidence interval [CI]) = 1.28 [0.92-1.79]). However, postoperative urinary retention was significantly higher among patients with BPH (OR [95% CI] = 3.43 [2.04-5.78]). Additionally, patients with BPH exhibited a notably elevated incidence of postoperative urinary tract infection (OR [95% CI] = 2.55 [2.33-2.79]), as well as sepsis (OR [95% CI] = 1.31 [1.09-1.58]).
It is noteworthy that while patients with BPH are prone to certain complications, meta-analysis indicate that BPH cannot be considered a comorbidity that increases the risk of periprosthetic joint infection.
全关节置换术（TJA）是每年最常进行的外科手术之一，具有相当高的成本效益和诸多益处。然而，TJA术后可观察到某些并发症。虽然各种合并症与这些并发症之间的关系已有充分记录，但本研究旨在具体调查良性前列腺增生（BPH）对术后结果的影响。
对于本系统评价，我们使用“全髋关节置换术”“全膝关节置换术”“BPH”和“良性前列腺肥大”等术语在PubMed、Scopus和Web of Science中进行检索。根据系统评价和Meta分析的首选报告项目指南对检索到的文章进行筛选。比较有和没有BPH病史的患者在TJA中并发症的研究符合纳入标准。对纳入的文章进行数据提取，并使用纽卡斯尔-渥太华量表评估其质量。采用Mantel-Haenszel方法进行Meta分析。
本系统评价纳入了4篇评估有BPH病史男性患者TJA结果的文章，共涉及75222例男性病例。其中，17183例（23%）出现有症状的BPH。Meta分析显示，在全髋关节和膝关节置换病例中，BPH组和非BPH组的假体周围关节感染发生率无显著差异（优势比[OR]（95%置信区间[CI]）=1.28[0.92-1.79]）。然而，BPH患者术后尿潴留明显更高（OR[9
