Comparing Prostate Treatments: PUL, PAE and TURP

What is it about?

This systematic review and network meta-analysis aimed to compare the clinical efficacy and safety of prostatic urethral lift (PUL) and prostatic artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) with transurethral resection of the prostate (TURP) or sham procedures as control interventions. Eight RCTs with 675 participants were included in the analysis. TURP was found to be the most efficacious intervention for clinical and functional outcomes and was associated with a lower reintervention rate compared with PAE and PUL. Indirect comparison revealed that PUL and PAE resulted in similar outcomes. PAE was associated with fewer minor adverse events compared with TURP, while PUL was associated with fewer major adverse events. The quality of evidence was relatively low due to the paucity of RCTs available.

Featured Image

Why is it important?

This research is important because it aims to assess and compare the clinical efficacy and safety of two minimally invasive procedures, prostatic urethral lift (PUL) and prostatic artery embolization (PAE), for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) using a systematic review and network meta-analysis. This study provides valuable insights into the relative effectiveness and safety of these two procedures compared to the standard surgical procedure, transurethral resection of the prostate (TURP), and sham procedures. Key Takeaways: 1. The most effective intervention for clinical and functional outcomes was TURP, which was associated with a lower reintervention rate compared to PAE and PUL. 2. PAE resulted in fewer minor adverse events compared to TURP, while PUL resulted in fewer major adverse events. 3. PUL was the best-ranked procedure regarding erectile function, but no significant difference was observed. 4. The quality of evidence is relatively low due to the paucity of randomized controlled trials available, and the results should be interpreted with caution.