CUA 2018: Photoselective Vaporization of The Prostate: Evaluation of Conflicts of Interest and Industrial Sponsorship Stratified by Outcome

Halifax, Nova Scotia ( Photoselective vaporization of the prostate (PVP) has been a widely accepted technique for the treatment of non-neurogenic lower urinary tract symptoms secondary to prostate enlargement. However, recently, it has been indicated that conflicts of interest (COIs) and industrial sponsorship (IS) may have some effects on the reporting of outcomes of studies assessing efficacy, safety, or cost parameters of PVP. Marian Wettstein, MD, a clinical urologist from the University of Zurich, thus presented her research on the validity of these claims. She intended to retrospectively evaluate COIs and IS stratified to the outcome of studies involving 80W, 120W, or 180W PVP systems. 

To conduct her literature search for this study, Dr. Wettstein used the MEDLINE and EMBASE databases for articles published between January of 1990 and August of 2017. The studies regarding the PVP treatment modality that were collected in this literature search were then separated into randomized controlled trials (RCT) and non-randomized control trials (NRCT). Two reviewers independently screened each article to determine whether each study had IS present or no IS. If the PVP treatment was deemed to be favorable, the study would be stratified into the appropriate, superior cohort; if the study determined unfavorable PVP treatment, it was stratified into the inferior cohort. Descriptive statistics were used for data analysis. 

At the time of the study’s completion, 286 articles were identified but 65 studies qualified for final analysis. The majority of these studies mentioned the absence/presence of potential COIs (n=51, 78%), however, an IS statement was only found in 29% of the studies. The study’s main data points are shown in the figure below.  
Wettstein Results COI IS
In closing, Dr. Wettstein explained that a majority of all RCTs and NRCTs regarding PVP give a statement regarding COI, while only about a third of studies mentioned IS. The major endpoint of this particular study was that trials that reported COIs and IS were more frequent in reporting favorable outcomes of PVP. Before leaving the podium, Dr. Wettstein advocated that reporting of COIs and IS in the field of urology must be improved in the future in order to deliver the best results with most accurate and transparent data as possible.  

Presented by Marian S. Wettstein, MD

Written by Zachary Valley, Department of Urology, University of California-Irvine, Twitter: @ZacharyAValley, at the 73rd Canadian Urological Association Annual Meeting - June 23 - 26, 2018 - Halifax, Nova Scotia