TY - JOUR
T1 - Diagnostic value of urodynamic bladder outlet obstruction to select patients for transurethral surgery of the prostate
T2 - Systematic review and meta-analysis
AU - Kim, Myong
AU - Jeong, Chang Wook
AU - Oh, Seung June
N1 - Funding Information:
This study was supported by grant no 23-2015-0050 from Seoul National University Hospital Research Fund. The authors are indebted to Jung-Yun Lee (E-mail: jungyunlee@yuhs.ac ), assistant professor, Department of Obstetrics and Gynecology, Yonsei University College of Medicine for his pro bono technical advice on our first meta-analysis.
Publisher Copyright:
© 2017 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/2
Y1 - 2017/2
N2 - Purpose To investigate the diagnostic value of urodynamic bladder outlet obstruction (BOO) in the selection of patients for transurethral surgery of the prostate. Materials and methods We systematically searched online PubMed, Embase, and Cochrane Library databases from January 1989 to June 2014. Results A total of 19 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2321 patients with a median number of 92 patients per study (range: 12-437). Of the 19 studies, 15 conducted conventional transurethral prostatectomy (TURP), and 7 used other or multiple modalities. In urodynamic bladder outlet obstruction (BOO) positive patients, the pooled mean difference (MD) was significant for better improvement of the International Prostate Symptom Score (IPSS) (pooled MD, 3.48; 95% confidence interval [CI], 1.72-5.24; p < 0.01; studies, 16; participants, 1726), quality of life score (QoL) (pooled MD, 0.56; 95% CI, 0.14-1.02; p = 0.010; studies, 9; participants, 1052), maximal flow rate (Qmax ) (pooled MD, 3.86; 95% CI, 2.17-5.54; p < 0.01; studies, 17; participants, 1852), and postvoid residual volume (PVR) (pooled MD, 32.46; 95% CI, 23.34-41.58; p < 0.01; studies, 10; participants, 1219) compared with that in non-BOO patients. Some comparisons showed between-study heterogeneity despite the strict selection criteria of the included studies. However, there was no clear evidence of publication bias in this meta-analysis. Conclusions Our meta-analysis results showed a significant association between urodynamic BOO and better improvements in all treatment outcome parameters. Preoperative UDS mayadd insight into postoperative outcomes after surgical treatment of benign prostatic hyperplasia.
AB - Purpose To investigate the diagnostic value of urodynamic bladder outlet obstruction (BOO) in the selection of patients for transurethral surgery of the prostate. Materials and methods We systematically searched online PubMed, Embase, and Cochrane Library databases from January 1989 to June 2014. Results A total of 19 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2321 patients with a median number of 92 patients per study (range: 12-437). Of the 19 studies, 15 conducted conventional transurethral prostatectomy (TURP), and 7 used other or multiple modalities. In urodynamic bladder outlet obstruction (BOO) positive patients, the pooled mean difference (MD) was significant for better improvement of the International Prostate Symptom Score (IPSS) (pooled MD, 3.48; 95% confidence interval [CI], 1.72-5.24; p < 0.01; studies, 16; participants, 1726), quality of life score (QoL) (pooled MD, 0.56; 95% CI, 0.14-1.02; p = 0.010; studies, 9; participants, 1052), maximal flow rate (Qmax ) (pooled MD, 3.86; 95% CI, 2.17-5.54; p < 0.01; studies, 17; participants, 1852), and postvoid residual volume (PVR) (pooled MD, 32.46; 95% CI, 23.34-41.58; p < 0.01; studies, 10; participants, 1219) compared with that in non-BOO patients. Some comparisons showed between-study heterogeneity despite the strict selection criteria of the included studies. However, there was no clear evidence of publication bias in this meta-analysis. Conclusions Our meta-analysis results showed a significant association between urodynamic BOO and better improvements in all treatment outcome parameters. Preoperative UDS mayadd insight into postoperative outcomes after surgical treatment of benign prostatic hyperplasia.
UR - http://www.scopus.com/inward/record.url?scp=85013999924&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0172590
DO - 10.1371/journal.pone.0172590
M3 - Article
C2 - 28241023
AN - SCOPUS:85013999924
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 2
M1 - e0172590
ER -