The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials

Tania Lourenco, Matthew Shaw, Cynthia Mary Fraser, Graeme Stewart MacLennan, James Michael Olu N'Dow, Robert Pickard

Research output: Contribution to journalArticle

38 Citations (Scopus)
3 Downloads (Pure)

Abstract

Transurethral incision of the prostate gland (TUIP) is perceived as a less morbid surgical alternative to standard transurethral resection of the prostate gland (TURP) for treatment of symptomatic mild to moderate benign prostate enlargement (BPE). We aimed to evaluate comparative clinical effectiveness of the two procedures.

Systematic review and meta-analysis of short- and long-term data from randomised controlled trials comparing TUIP with TURP.

This review considered data from 795 randomised participants across 10 RCTs of moderate to poor quality 8 of which stated an upper limit for prostate size. No difference in the degree of symptomatic improvement was seen between the two procedures. Improvement in peak urine flow rate was lower for TUIP compared to TURP whilst the rate of blood transfusion and TUR syndrome was higher after TURP. Urinary retention, urinary tract infection, strictures and incontinence did not differ between the two approaches, although clinically important differences could not be ruled-out. TUIP was associated with a shorter duration of operation and length of hospital stay but a higher re-operation rate.

TUIP and TURP appear to offer equivalent symptomatic improvement for men with mild to moderate BPE. Choosing TUIP involves a trade-off between the lower risk of peri-operative morbidity and the higher risk of subsequent re-operation.

Original languageEnglish
Pages (from-to)23-32
Number of pages10
JournalWorld Journal of Urology
Volume28
Issue number1
DOIs
Publication statusPublished - Feb 2010

Keywords

  • Benign prostate enlargement
  • Transurethral incision of prostate
  • Transurethral resection of prostate
  • Meta-analysis
  • Systematic review
  • URINARY-TRACT SYMPTOMS
  • BLADDER NECK INCISION
  • SMALL BENIGN PROSTATE
  • RESECTION
  • QUALITY
  • HYPERTROPHY
  • HYPERPLASIA
  • OBSTRUCTION
  • MEN

Cite this

The clinical effectiveness of transurethral incision of the prostate : a systematic review of randomised controlled trials. / Lourenco, Tania; Shaw, Matthew; Fraser, Cynthia Mary; MacLennan, Graeme Stewart; N'Dow, James Michael Olu; Pickard, Robert.

In: World Journal of Urology, Vol. 28, No. 1, 02.2010, p. 23-32.

Research output: Contribution to journalArticle

@article{d89be0e30d3d4efbbb34d4d0dfa642a7,
title = "The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials",
abstract = "Transurethral incision of the prostate gland (TUIP) is perceived as a less morbid surgical alternative to standard transurethral resection of the prostate gland (TURP) for treatment of symptomatic mild to moderate benign prostate enlargement (BPE). We aimed to evaluate comparative clinical effectiveness of the two procedures.Systematic review and meta-analysis of short- and long-term data from randomised controlled trials comparing TUIP with TURP.This review considered data from 795 randomised participants across 10 RCTs of moderate to poor quality 8 of which stated an upper limit for prostate size. No difference in the degree of symptomatic improvement was seen between the two procedures. Improvement in peak urine flow rate was lower for TUIP compared to TURP whilst the rate of blood transfusion and TUR syndrome was higher after TURP. Urinary retention, urinary tract infection, strictures and incontinence did not differ between the two approaches, although clinically important differences could not be ruled-out. TUIP was associated with a shorter duration of operation and length of hospital stay but a higher re-operation rate.TUIP and TURP appear to offer equivalent symptomatic improvement for men with mild to moderate BPE. Choosing TUIP involves a trade-off between the lower risk of peri-operative morbidity and the higher risk of subsequent re-operation.",
keywords = "Benign prostate enlargement, Transurethral incision of prostate, Transurethral resection of prostate, Meta-analysis, Systematic review, URINARY-TRACT SYMPTOMS, BLADDER NECK INCISION, SMALL BENIGN PROSTATE, RESECTION, QUALITY, HYPERTROPHY, HYPERPLASIA, OBSTRUCTION, MEN",
author = "Tania Lourenco and Matthew Shaw and Fraser, {Cynthia Mary} and MacLennan, {Graeme Stewart} and N'Dow, {James Michael Olu} and Robert Pickard",
note = "The original publication is available at www.springerlink.com.",
year = "2010",
month = "2",
doi = "10.1007/s00345-009-0496-8",
language = "English",
volume = "28",
pages = "23--32",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - The clinical effectiveness of transurethral incision of the prostate

T2 - a systematic review of randomised controlled trials

AU - Lourenco, Tania

AU - Shaw, Matthew

AU - Fraser, Cynthia Mary

AU - MacLennan, Graeme Stewart

AU - N'Dow, James Michael Olu

AU - Pickard, Robert

N1 - The original publication is available at www.springerlink.com.

PY - 2010/2

Y1 - 2010/2

N2 - Transurethral incision of the prostate gland (TUIP) is perceived as a less morbid surgical alternative to standard transurethral resection of the prostate gland (TURP) for treatment of symptomatic mild to moderate benign prostate enlargement (BPE). We aimed to evaluate comparative clinical effectiveness of the two procedures.Systematic review and meta-analysis of short- and long-term data from randomised controlled trials comparing TUIP with TURP.This review considered data from 795 randomised participants across 10 RCTs of moderate to poor quality 8 of which stated an upper limit for prostate size. No difference in the degree of symptomatic improvement was seen between the two procedures. Improvement in peak urine flow rate was lower for TUIP compared to TURP whilst the rate of blood transfusion and TUR syndrome was higher after TURP. Urinary retention, urinary tract infection, strictures and incontinence did not differ between the two approaches, although clinically important differences could not be ruled-out. TUIP was associated with a shorter duration of operation and length of hospital stay but a higher re-operation rate.TUIP and TURP appear to offer equivalent symptomatic improvement for men with mild to moderate BPE. Choosing TUIP involves a trade-off between the lower risk of peri-operative morbidity and the higher risk of subsequent re-operation.

AB - Transurethral incision of the prostate gland (TUIP) is perceived as a less morbid surgical alternative to standard transurethral resection of the prostate gland (TURP) for treatment of symptomatic mild to moderate benign prostate enlargement (BPE). We aimed to evaluate comparative clinical effectiveness of the two procedures.Systematic review and meta-analysis of short- and long-term data from randomised controlled trials comparing TUIP with TURP.This review considered data from 795 randomised participants across 10 RCTs of moderate to poor quality 8 of which stated an upper limit for prostate size. No difference in the degree of symptomatic improvement was seen between the two procedures. Improvement in peak urine flow rate was lower for TUIP compared to TURP whilst the rate of blood transfusion and TUR syndrome was higher after TURP. Urinary retention, urinary tract infection, strictures and incontinence did not differ between the two approaches, although clinically important differences could not be ruled-out. TUIP was associated with a shorter duration of operation and length of hospital stay but a higher re-operation rate.TUIP and TURP appear to offer equivalent symptomatic improvement for men with mild to moderate BPE. Choosing TUIP involves a trade-off between the lower risk of peri-operative morbidity and the higher risk of subsequent re-operation.

KW - Benign prostate enlargement

KW - Transurethral incision of prostate

KW - Transurethral resection of prostate

KW - Meta-analysis

KW - Systematic review

KW - URINARY-TRACT SYMPTOMS

KW - BLADDER NECK INCISION

KW - SMALL BENIGN PROSTATE

KW - RESECTION

KW - QUALITY

KW - HYPERTROPHY

KW - HYPERPLASIA

KW - OBSTRUCTION

KW - MEN

U2 - 10.1007/s00345-009-0496-8

DO - 10.1007/s00345-009-0496-8

M3 - Article

VL - 28

SP - 23

EP - 32

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 1

ER -