Anterograde ejaculation preservation after endoscopic treatments in patients with bladder outlet obstruction: systematic review and pooled-analysis of randomized clinical trials
Abstract
INTRODUCTION
Despite the high rate of resolution, ejaculatory dysfunction (EjD) still is the most common side effect related to surgical treatment of bladder outlet obstruction (BOO). The aim of the present systematic review is to investigate how several technological treatment modalities for the management of LUTS/BOO compare in terms of functional and sexual outcomes.
EVIDENCE ACQUISITION
All English language randomized controlled trials (RCT) assessing the impact of different endoscopic treatments for BOO were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus®, and Web of ScienceTM databases (up to June 2019).
EVIDENCE SYNTHESIS
Our electronic search identified a total of 2221 papers in PubMed, Scopus, and Web of Science. Of these, 142 publications were identified for detailed review, which yielded 21 included in the present systematic review. All groups appeared similar with regards to preoperative IPSS/AUA score, Qmax, and prostate volume (cc). Patients undergoing endoscopic treatments using ThuLEP, Greenlight or Prostate Artery Embolization techniques had lower-but not statistically significant- relative risk (RR) of retrograde ejaculation compared with conventional TURP (RR:0.90;p=0.35; RR: 0.71; p=0.1; RR0.73; p=0.11). Efficacy of those techniques was equal to TURP.
CONCLUSIONS
Data reporting anterograde ejaculation preservation after endoscopic treatment in patients with BPE…
How strong is the evidence?
Evidence Hub reads this as a systematic review, 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.
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