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Bladder neck stenosis after transurethral prostate surgery: a systematic review and meta-analysis
Daniele Castellani1, Marcelo Langer Wroclawski2,3, Giacomo Maria Pirola4
1Department of Urology, University Hospital "Ospedali Riuniti" and Polytechnic University of Marche Region, via Conca 71, 60126, Ancona, Italy.
World Journal of Urology
|May 11, 2021
Summary
Bladder neck stenosis (BNS) incidence after benign prostatic hyperplasia (BPH) surgery shows no significant difference between transurethral resection of the prostate (TURP), ablation, and enucleation. This meta-analysis provides a reference for counseling patients on surgical outcomes.
Area of Science:
- Urology
- Surgical Oncology
- Medical Informatics
Background:
- Bladder neck stenosis (BNS) is a known long-term complication following surgical treatment for benign prostatic hyperplasia (BPH).
- Transurethral surgical procedures are common for BPH, but carry risks of complications like BNS.
Purpose of the Study:
- To systematically review and meta-analyze the incidence of BNS after various transurethral surgical procedures for BPH.
- To compare the rates of BNS following transurethral resection of the prostate (TURP) versus ablation and enucleation techniques.
Main Methods:
- Systematic literature review of randomized trials from MEDLINE, EMBASE, and Cochrane Central.
- Meta-analysis using the Cochran-Mantel-Haenszel Method with random effect model to pool BNS incidence.
- Comparison of TURP against ablation and enucleation modalities, assessing risk ratios, confidence intervals, and heterogeneity (I²).
Main Results:
- 72 studies were included: 46 comparing TURP vs. Ablation, 26 comparing TURP vs. Enucleation.
- Pooled BNS incidence: 1.3% (TURP), 0.66% (Enucleation), 1.2% (Ablation).
- No statistically significant difference in BNS incidence between TURP and Enucleation (RR 1.75, p=0.16) or TURP and Ablation (RR 1.31, p=0.26). Significant heterogeneity was absent (I²=0%).
Conclusions:
- This meta-analysis indicates no significant difference in BNS incidence among randomized trials comparing TURP, ablation, and enucleation for BPH.
- Findings can serve as a valuable reference for patient counseling regarding the risk of BNS after different surgical approaches for BPH.
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