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18.11.2023 | Invited Review

Comparison of EEP and TURP long-term outcomes: systematic review and meta-analysis

verfasst von: Andrey Morozov, Mark Taratkin, Anastasia Shpikina, Yaron Ehrlich, Jonathan McFarland, Alim Dymov, Vasiliy Kozlov, Harun Fajkovic, Juan Gomez Rivas, Lukas Lusuardi, Jeremy Yuen-Chun Teoh, Thomas Herrmann, Jack Baniel, Dmitry Enikeev

Erschienen in: World Journal of Urology | Ausgabe 12/2023

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Abstract

Objective

To compare long-term reoperation rate and functional outcomes between EEP (endoscopic enucleation of the prostate) and TURP (transurethral resection of the prostate).

Evidence acquisition

A systematic literature review of Medline, Scopus, and Web of Science was conducted with primary outcome assessed being reoperation rate and secondary outcomes after a long term (> 3 years) being functional outcomes or related values (prostate volume, PSA level, etc.).

Evidence synthesis

Five studies were found with long-term follow-up 4–7 years. EEP reoperation rate ranged from 0 to 1.27%, while from 1.7 to 17.6% for TURP. Meta-analysis showed significantly lower OR for EEP, 0.27 (95% CI 0.24–0.31), with notable homogeneity of the results, I² = 0%. Long-term Qmax and IPSS were significantly better for EEP. Q_max pooled mean difference was 1.79 (95% CI 1.72–1.86) ml/s with a high concordance among the studies, I² = 0%. IPSS mean difference −1.24 (95% CI − 1.28 to − 1.2) points, I² = 57% but QoL did not differ, with mean difference being 0.01 (95% CI − 0.02 to 0.04), I² = 0%. IIEF-5 score was also significantly better for EEP, mean difference 1.08 (95% CI 1.03–1.13), but heterogeneity was high, I² = 70%. PSA level and prostate volume were only reported in one study and favored EEP slightly yet statistically significant.

Conclusion

EEP had a significantly lower reoperation rate and better functional outcomes (Q_max and IPSS) at long term compared with TURP. It may also be beneficial in terms of IIEF-5, PVR, and PSA level.

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Titel: Comparison of EEP and TURP long-term outcomes: systematic review and meta-analysis
verfasst von: Andrey Morozov
Mark Taratkin
Anastasia Shpikina
Yaron Ehrlich
Jonathan McFarland
Alim Dymov
Vasiliy Kozlov
Harun Fajkovic
Juan Gomez Rivas
Lukas Lusuardi
Jeremy Yuen-Chun Teoh
Thomas Herrmann
Jack Baniel
Dmitry Enikeev
Publikationsdatum: 18.11.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 12/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04666-8

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Comparison of EEP and TURP long-term outcomes: systematic review and meta-analysis