Comparison between minimally invasive simple prostatectomy and open simple prostatectomy for large prostates: A systematic review and meta-analysis of comparative trials.

Although previous studies have compared the minimally invasive simple prostatectomy (MISP) with open simple prostatectomy (OSP) for large prostates, there is still controversy. This current study aims to provide the latest evidence for clinical practice.

We systematically searched Science, EMBASE, PubMed and Clinicalkey databases for articles comparing MISP and OSP for large prostates. Result parameters including International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume (PVR), operative time (OT), estimated blood loss (EBL), irrigation time (IT), catheterization time (CT), length of hospital stay (LOS), transfusion rate (TR), and complications were evaluated using RevMan 5.3.

A total of 995 patients were included in 10 studies. No statistically significant differences were found between two groups in IPSS (WMD: -0.36, P = 0.26), QoL (WMD: -0.22, P = 0.05), Qmax (WMD: 0.46, P = 0.62) and PVR (WMD: -2.14, P = 0.65). The MISP group had similar IT (WMD: -1.52, P = 0.06), lesser EBL (WMD: -292.22, P < 0.001), shorter CT (WMD: -1.89, P < 0.0001), shorter LOS (WMD: -2.52, P < 0.001), lower TR (OR: 0.21, P < 0.001) and lower complications (OR: 0.49, P < 0.001) compared with OSP group. However, the OT (WMD: 43.07, P < 0.001) of MISP was longer than that of OSP.

The present results demonstrated that MISP provided similar efficacy to those of OSP, while maintaining a better security. Our findings imply that MISP is a feasible and effective alternative to the OSP.

Journal of endourology. 2019 Jun 27 [Epub ahead of print]

Jinze Li, Dehong Cao, Lei Peng, Zhengju Ren, Haocheng Gou, Yunxiang Li, Qiang Wei

Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nanchong, China ; ., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China., Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nanchong, China ; ., Sichuan University West China Hospital, 34753, Urology, Chengdu, Sichuan, China ; ., Department of Otolaryngology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nanchong, Sichuan, China ; ., Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nanchong, China ; ., Sichuan University West China Hospital, 34753, Urology, Chengdu, Sichuan, China ; .