https://doi.org/10.4081/aiua.2024.12066

The efficacy and safety of prostatic urethral lift as a minimally invasive therapeutic modality to treat lower urinary tract symptoms while maintaining sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials

Vol. 96 No. 1 (2024)
Submitted: November 9, 2023
Accepted: December 5, 2023
Published: March 7, 2024
Benign prostatic hyperplasia, lower urinary tract symptoms, prostathic urethral lift, quality of life, sexual function
Abstract Views: 766
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Authors

Syah Mirsya Warli
warli@usu.ac.id
https://orcid.org/0000-0002-8339-1072
Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan; Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara-Haji Adam Malik General Hospital, Medan, Indonesia.
Muhammad Fahmi Ikram
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Raja Gerald Sarumpaet
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Zaimah Zulkarnaini Tala
Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Indonesia.
Ignatius Ivan Putrantyo
Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan, Indonesia.

Background: Benign prostatic hyperplasia (BPH) is prevalent among elderly men, necessitating focused attention. The Prostatic Urethral Lift (PUL) procedure, a minimally invasive intervention, has emerged as a promising option for BPH management. It has shown remarkable results in ameliorating lower urinary tract symptoms (LUTS), enhancing quality of life, and preserving sexual function. This study aims to evaluate the effectiveness and safety of PUL in BPH patients.
Methods: Key databases (MEDLINE, Cochrane CENTRAL, ScienceDirect, EBSCO, Google Scholar) were systematically searched using pertinent terms related to PUL and BPH. Following the PRISMA checklist, we considered only randomized controlled trials (RCTs) from 2013 to 2023. The assessment focused on LUTS, quality of life, sexual function, and adverse events within three months. Follow-up post-treatment mean values compared with controls (Sham) and the improvement from baseline to post-treatment follow-up duration were considered. Statistical analysis and risk of bias evaluation were conducted using Review Manager 5.4.1, presenting results as difference of mean values (MD) and risk ratios (RR).
Results: A meta-analysis with a Random Effects Model of 7 RCTs involving 378 confirmed BPH patients demonstrated significant improvements in the PUL arm including International Prostate Symptom Score (IPSS) (MD 5.51, p<0.0001), maximum urinary flow rate (Qmax) (MD 2.13, p=0.0001), BPH Impact Index (BPHII) (MD 2.14, p=0.0001), and IPSS-QoL (MD 1.50, p<0.0001), without significant increase of adverse events (RR 1.51; p=0.50). Positive outcomes were observed in sexual function variables and post-void residual measurements when post-treatment values were compared to baseline.
Conclusions: PUL holds advantages over control interventions, providing encouraging prospects for BPH management. This study underscores the need for further exploration of PUL's efficacy and safety in BPH patients.

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How to Cite

Warli, S. M., Ikram, M. F., Sarumpaet, R. G., Tala, Z. Z., & Putrantyo, I. I. (2024). The efficacy and safety of prostatic urethral lift as a minimally invasive therapeutic modality to treat lower urinary tract symptoms while maintaining sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12066
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