Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11812-11826
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11812
Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and meta-analysis
Xiao-Yan Wang, Yu-Meng Chai, Wen-Hui Huang, Yong Zhang
Xiao-Yan Wang, Yu-Meng Chai, Yong Zhang, Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Wen-Hui Huang, School of Information Science and Engineering, Shandong Normal University, Jinan 250014, Shandong Province, China
Author contributions: Wang XY and Chai YM contributed equally to this work; Wang XY, Chai YM and Zhang Y designed the research study; Wang XY and Chai YM performed the research; Huang WH contributed analytic tools; Wang XY, Chai YM and Huang WH analyzed the data, Wang XY and Chai YM wrote the manuscript; all authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declared that they have no conflict of interest in connection with the work submitted.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Zhang, MD, Doctor, Department of Urology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Beijing 100070, China. 18610711834@163.com
Received: August 5, 2022
Peer-review started: August 5, 2022
First decision: September 23, 2022
Revised: September 28, 2022
Accepted: October 17, 2022
Article in press: October 17, 2022
Published online: November 16, 2022
Abstract
BACKGROUND

Prostate artery embolization (PAE) is a promising minimally invasive therapy that improves lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) is the gold standard therapy for LUTS/BPH.

AIM

To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH.

METHODS

A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH. Sources included PubMed, Embase, Cochrane library databases, and Chinese databases before June 2022. A systematic review and meta-analysis were conducted. Outcome measurements were combined by calculating the mean difference with a 95% confidence interval. Statistical analysis was carried out using Review Manager 5.3.

RESULTS

Eleven studies involving 1070 participants were included. Compared with the TURP group, the PAE group had a similar effect on the International Index of Erectile Function (IPSS) score, Peak urinary flow rate (Qmax), postvoid residual volume (PVR), Prostate volume (PV), prostatic specific antigen (PSA), The International Index of Erectile Function short form (IIEF-5) scores, and erectile dysfunction during 24 mo follow-up. Lower quality of life (QoL) score, lower rate of retrograde ejaculation and shorter hospital stay in the PAE group. There was no participant death in either group. A higher proportion of haematuria, urinary incontinence and urinary stricture was identified in the TURP group.

CONCLUSION

PAE may be an appropriate option for elderly patients, patients who are not candidates for surgery, and patients who do not want to risk the potential adverse effects of TURP. Studies with large cases and long follow-up time are needed to validate results.

Keywords: Lower urinary tract symptoms, Benign prostatic hyperplasia, Meta-analysis, Prostate artery embolization, Transurethral resection of the prostate

Core Tip: Prostate artery embolization (PAE) is a promising minimally invasive therapy that improves lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). Transurethral resection of the prostate (TURP) is the gold standard therapy for LUTS/BPH. This article uses a meta-analysis to evaluate the efficacy and safety of PAE compared with TURP on LUTS related to BPH. In our conclusion, PAE may be an appropriate option for elderly patients, patients who are not candidate for surgery, and patients who do not want to risk the potential adverse effects of TURP.