Efficacy and safety of urethral sparing versus other robot-assisted simple prostatectomy for large volume benign prostatic hyperplasia: a systematic review and meta-analysis
Abstract
This study aim to evaluate the efficacy and safety of urethra-sparing robot-assisted simple prostatectomy (US-RASP) compared to conventional robot-assisted simple prostatectomy (RASP) for treating large-volume benign prostatic hyperplasia (BPH), with particular attention to preserving ejaculatory function. A thorough search was conducted across PubMed, Web of Science, EMBASE, and Cochrane Library databases for studies published until September 26, 2024. Five cohort studies involving 771 patients met the inclusion criteria. Data on perioperative outcomes, International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD), Maximum Flow Rate (Qmax), Post-Void Residual Volume (PVR), Quality of Life (QoL) and complications were extracted and analyzed using RevMan 5.3 and Stata 15. The meta-analysis revealed that US-RASP was markedly more effective than RASP in preserving ejaculatory function (MSHQ-EjD, WMD 8.09, 95% CI 5.92–10.26, p < 0.0001). No notable differences were identified between the two approaches regarding IPSS, IIEF, Qmax, PVR, QoL, operative time, or intraoperative blood loss and complications. Nonetheless, US-RASP showed benefits in shortening hospital stay and catheterization time. US-RASP offers significant benefits in preserving ejaculatory function and is comparable to RASP in terms of safety and efficacy. It is a preferable option for younger patients or those…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 771 participants or records.
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