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World Journal of Urology
Erschienen in: World Journal of Urology 6/2022

13.02.2022 | Invited Review

Urethral stricture following endoscopic prostate surgery: a systematic review and meta-analysis of prospective, randomized trials

verfasst von: Giacomo Maria Pirola, Daniele Castellani, Ee Jean Lim, Marcelo Langer Wroclawski, Dong Le Quy Nguyen, Marilena Gubbiotti, Emanuele Rubilotta, Vinson Wai-Shun Chan, Mariela Corrales, Esther García Rojo, Thomas R. W. Herrmann, Jeremy Yuen-Chun Teoh, Vineet Gauhar

Erschienen in: World Journal of Urology | Ausgabe 6/2022

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Abstract

Introduction and objectives

This systematic review aims to evaluate the incidence and influencing factors of urethral stricture (US) in relation to different BPH endoscopic techniques.

Materials and methods

We performed a systematic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. The incidence of US was estimated through comparative studies between different endoscopic techniques. Patients were assigned into groups according to the type of surgery (enucleation, ablation and resection group). Incidences of US were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and reported as Risk Ratio (RR), 95% Confidence Intervals (CI), and p-values.

Results

A total of 80 studies were included for meta-analysis. The pooled incidence of US was 1.7% after enucleation, 2.1% after ablation, 3.8% after monopolar (M)-TURP and 2.1% after bipolar (B)-TURP. The incidence of US was significantly lower after Enucleation than after TURP (RR 0.58 95% CI 0.39–0.84, p = 0.004). US incidence was lower for Ablation procedures than TURP, but the difference did not reach significance (RR 0.79 95% CI 0.61–1.3, p = 0.08). However, this was significant in the subgroup of M-TURP studies (RR 0.67, 95% CI, 0.49–0.91, p = 0.01). Sub-analysis showed that the risk of US was significantly lower after Enucleation than after TURP within 12 months after surgery (RR 0.51 95% CI 0.33–0.81, p = 0.004).

Conclusion

The study shows an increased incidence of US after TURP compared to enucleation and ablation procedures. The main factors related to increased US incidence are the use of monopolar energy, instrument caliber and duration of postoperative catheterization.
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Metadaten
Titel
Urethral stricture following endoscopic prostate surgery: a systematic review and meta-analysis of prospective, randomized trials
verfasst von
Giacomo Maria Pirola
Daniele Castellani
Ee Jean Lim
Marcelo Langer Wroclawski
Dong Le Quy Nguyen
Marilena Gubbiotti
Emanuele Rubilotta
Vinson Wai-Shun Chan
Mariela Corrales
Esther García Rojo
Thomas R. W. Herrmann
Jeremy Yuen-Chun Teoh
Vineet Gauhar
Publikationsdatum
13.02.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 6/2022
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-022-03946-z

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Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

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