Shedding light on polypragmasy of pain after transurethral prostate surgery procedures: a systematic review and meta-analysis.

Autor: Wroclawski ML; Hospital Israelita Albert Einstein, São Paulo, Brazil. urologia.marcelo@gmail.com.; BP-a Beneficência Portuguesa de São Paulo, São Paulo, Brazil. urologia.marcelo@gmail.com.; Faculdade de Medicina Do ABC, Santo André, Brazil. urologia.marcelo@gmail.com., Castellani D; Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, Ancona, Italy., Heldwein FL; Department of Urology, Federal University of Santa Catarina, Florianópolis, Brazil., Teles SB; Hospital Israelita Albert Einstein, São Paulo, Brazil., Cha JD; Hospital Israelita Albert Einstein, São Paulo, Brazil., Zhao H; S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China., Herrmann T; Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland.; Department of Urology, Hanover Medical School (MHH), Hanover, Germany., Chan VW; School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK., Teoh JY; S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2021 Oct; Vol. 39 (10), pp. 3711-3720. Date of Electronic Publication: 2021 Mar 31.
DOI: 10.1007/s00345-021-03678-6
Abstrakt: Purpose and Objective: To evaluate and compare the incidences of post-operative pelvic pain (PPP) in patients undergoing ablation, enucleation and conventional transurethral resection of the prostate (TURP).
Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines. Using MEDLINE via PubMed and Cochrane CENTRAL, randomised control trials (RCTs) and observational studies reporting PPP rates post-ablation, enucleation or TURP were identified. The risk of biases (RoB) in RCTs and observation studies were assessed using the Cochrane RoB1.0 tool and the Newcastle-Ottawa Scale, respectively.
Results: 62 studies were included for qualitative analysis, while 51 of them reported number of patients with PPP post-intervention. Three observational studies and 13 RCTs compared the rates of PPP in patients undergoing ablation, enucleation or TURP. The most reported types of PPP are dysuria, abdominal pain and irritative symptoms. The pooled incidence of PPP at 1-month follow-up in patients undergoing ablation, enucleation and TURP were 0.15 (95% CI 0.10-0.22), 0.09 (95% CI 0.04-0.19 and 0.10 (95% CI 0.06-0.15), respectively. PPP is no longer prevalent at 3-months and onwards post-operatively. Ablation is associated with a higher risk of PPP than enucleation (RR 2.19, 95% CI 1.04-4.62) and TURP (RR 2.40, 95% CI 1.03-5.62) in observational studies but not RCTs; and there were no significant differences in the rates of PPP upon comparison of other modalities.
Conclusion: PPP is common after transurethral benign prostatic hyperplasia surgery. Patients undergoing ablation had a higher rate of post-intervention PPP than those undergoing enucleation and TURP in observational studies.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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