Recovery of Detrusor Function after Transurethral Prostatectomy in Patients with Benign Prostatic Hyperplasia and Underactive Detrusor: A Systematic Review and Meta-analysis | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2023, Issue 1, January 2023 | ||||
| DOI: 10.58675/2682-339X.1861 | ||||
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| Authors | ||||
| Mahmoud Ismael1; Mahmoud mohammed Ali2; Hasan abdelazim Mohammed2 | ||||
| 1Urology department, faculty of medicine, Al-Azhar university, Cairo | ||||
| 2Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Purpose: To determine the recovery potential of detrusor function in patients with symptomatic Benign Prostatic Hyperplasia (BPH) and Detrusor Underactivity (DU) who underwent transurethral prostatectomy. Materials and Methods: We systematically performed an online search via Pub Med, Embase, Google scholar and databases of Cochrane Library for articles published till June 2022 ,the selected studies included Patients with symptomatic BPH with urodynamically confirmed DU who underwent transurethral prostatectomy , these studies are original articles published in English languish, randomized or non-randomized, retrospective or prospective. Research that couldn't meet the aforementioned inclusion criteria, review articles, letters, experimental studies, and studies with inadequate data to estimate the results were all omitted. Results: We systemically reviewed eleven selected studies after A total of 4811 records were obtained, our meta-analysis showed relative recovery of detrusor function after Transurethral Prostatectomy in Patients with Benign Prostatic Hyperplasia and Detrusor Underactivity.however , further studies are needed regarding this subject. Eleven studies were included in this systematic review. Seven of these studies are retrospective studies, while the remaining four studies are prospective studies. 9 out of 11 studies reported TURP or TURP/TUIP as the standard intervention, 1 study with Holmium Laser Enucleation of the Prostate (HOLEP) and the remaining study used Photo Vaporization of the Prostate (PVP) as standard procedure. All studies included in the review reported Q max and PVR as parameters for assessment pre and post-operatively, while Bladder Contractility Index (BCI) , which is the most important parameter, was mentioned only in 2 studies with complete and satisfactory data. Some of the studies reported BCI as a pre-operative assessment but had no post-operative data. We tried to contact some of the authors to collect the missing data, but got no response. Pressure of detrusor at Q max (Pdet at Qmax) was reported in 3 studies , International Prostatic Symptom Score (IPSS) in 9 studies ,Quality of Life (QOL) in 7, and Voiding Effeciency (VE) and urinary bladder Compliance were reported only in 2 studies. The number of analysed patients in our included studies ranged from 20 to 250 patients. Time of outcome evaluation was mostly at 12 months except for 2 studies, which were at 6 months and another study at 3 months. conclusions: Our meta-analysis results showed that patients with BPH and DU who underwent transurethral prostatectomy showed improvement of Uro-dynamic (UD) parameters post-operatively. | ||||
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