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02.11.2018 | Original Article | Ausgabe 7/2019

World Journal of Urology 7/2019

Photoselective vaporization has comparative efficacy and safety among high-risk benign prostate hyperplasia patients on or off systematic anticoagulation: a meta-analysis

Zeitschrift:
World Journal of Urology > Ausgabe 7/2019
Autoren:
Xiaonan Zheng, Yuxuan Qiu, Shi Qiu, Liansha Tang, Kailei Nong, Xin Han, Min Li, Liuliu Quan, Lu Yang, Qiang Wei
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00345-018-2530-1) contains supplementary material, which is available to authorized users.
Xiaonan Zheng, Yuxuan Qiu and Shi Qiu have contributed equally to this work.

Abstract

Purpose

The necessity to cease anticoagulation before photoselective vaporization (PVP) surgery remains nonconsensual. We aimed at assessing the efficacy and safety of PVP among high-risk benign prostate hyperplasia (BPH) patients on or off anticoagulation.

Methods

We systematically searched Pubmed, Embase, and Cochrane Library Central Register of Controlled Trials (CENTRAL). 2299 patients from 11 studies were eventually included. Newcastle–Ottawa Scale (NOS) was employed to assess the quality and risk of bias of each study. All statistical analyses were conducted with Review Manager v.5.3 software.

Results

Ten parameters (operation time, laser time, blood transfusion, urethral stricture, urinary tract infection, reoperation, dysuria, capsule perforation, catheterization time, and re-catheterization) from patients on or off anticoagulant therapy were collected. The patients without anticoagulants performed better at catheterization time [MD − 0.54, 95% CI (− 0.82, − 0.26), P = 0.96, I2 = 0] with a reduction of 0.54 day than those on anticoagulants. Significant statistical difference was not observed from other parameters. Subgroup analysis, grouped by the power output of PVP systems (80 W, 120 W and 180 W), consistently showed no statistical significant difference except at catheterization time in the 180-W PVP subgroup.

Conclusion

PVP, a safe and effective option for high-risk BPH patients, work comparably regardless of anticoagulant therapy, despite non-anticoagulant patients have shorter catheterization time. It is implied that the use of anticoagulants might be unnecessary to stop for high-risk BPH patients undergoing PVP for the sake of safety, which certainly requires further investigations to confirm.

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