دورية أكاديمية
أعرض في EDS

Minimally invasive surgical therapies for benign prostatic hyperplasia in the geriatric population: A systematic review.

التفاصيل البيبلوغرافية
العنوان: Minimally invasive surgical therapies for benign prostatic hyperplasia in the geriatric population: A systematic review.
المؤلفون: Abid A; Hackensack Meridian School of Medicine, Nutley, New Jersey, USA., Piperdi H; Touro College of Osteopathic Medicine, New York, New York, USA., Babar M; Albert Einstein College of Medicine, Bronx, New York, USA., Loloi J; Department of Urology, Montefiore Medical Center, Bronx, New York, USA., Moutwakil A; Stanford University, Stanford, California, USA., Azhar U; Albert Einstein College of Medicine, Bronx, New York, USA., Maria P; Department of Urology, Montefiore Medical Center, Bronx, New York, USA., Small A; Department of Urology, Montefiore Medical Center, Bronx, New York, USA.
المصدر: The Prostate [Prostate] 2024 Jul; Vol. 84 (10), pp. 895-908. Date of Electronic Publication: 2024 Apr 24.
نوع المنشور: Journal Article; Systematic Review; Review
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 8101368 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0045 (Electronic) Linking ISSN: 02704137 NLM ISO Abbreviation: Prostate Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: New York : Alan R. Liss, c1980-
مواضيع طبية MeSH: Prostatic Hyperplasia*/surgery , Minimally Invasive Surgical Procedures*/methods, Humans ; Male ; Aged ; Aged, 80 and over ; Treatment Outcome ; Prostatectomy/methods
مستخلص: Background: Geriatric patients, prone to adverse events (AEs) and low compliance with drugs, may benefit from minimally invasive surgical therapies (MISTs) for managing benign prostatic hyperplasia (BPH). We evaluated the efficacy, safety, and procedural characteristics of MISTs in geriatric patients with BPH.
Methods: PubMed/MEDLINE database was systematically searched for relevant articles through October 1, 2023. Eligible studies focused on geriatric patients (≥65 years) with BPH who were treated with MISTs and evaluated follow-up surgical, micturition, and/or sexual outcomes. Studies were included if there was separate reporting for age subgroups ≥65 years, or if the mean age minus standard deviation was ≥65 years, or if the first quartile was ≥65 years.
Results: Out of 292 screened studies, 32 (N = 3972 patients) met inclusion criteria and assessed prostatic artery embolization (PAE), Rezum, GreenLight, holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), diode laser enucleation of the prostate (DiLEP), and Aquablation. Except for Rezum, all MISTs required a planned overnight stay. While PAE and Rezum could be performed under local anesthesia, the other MISTs needed general or spinal anesthesia. Postoperative catheterization duration was longest for PAE (median 14 days) and Rezum (21 days) and shortest for GreenLight (1.9 days). At 12 months postoperatively, all MISTs exhibited significant percent changes in International Prostate Symptom Score (median -69.9%) and quality of life (median -72.5%). Clavien-Dindo Grade 1 AEs ranged widely, with PAE (5.8%-36.8%), Rezum (0%-62.1%), and GreenLight (0%-67.6%) having the largest range, and HoLEP (0%-9.5%), ThuLEP (2%-6.9%), and DiLEP (5%-17.5%) having the smallest. PAE, Rezum, DiLEP, and Aquablation reported no significant changes in the International Index of Erectile Function.
Conclusions: Although all the MISTs reviewed in this study effectively treat BPH in geriatric patients, differences in procedural characteristics and safety profiles across MISTs were considerable. Physicians should use shared decision-making processes, considering risks and patient characteristics, when choosing a suitable treatment option for their patients.
(© 2024 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: benign prostatic hyperplasia; lower urinary tract symptoms; minimally invasive surgical procedures; prostate; prostatic diseases
تواريخ الأحداث: Date Created: 20240424 Date Completed: 20240603 Latest Revision: 20240603
رمز التحديث: 20240603
DOI: 10.1002/pros.24717
PMID: 38656693
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-0045
DOI:10.1002/pros.24717