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Radical prostatectomy after previous transurethral resection of the prostate: oncological, surgical and functional outcomes—a meta-analysis

  • Hai Liao
  • Xi Duan
  • Yong Du
  • Xiaoxi Mou
  • Tinghui Hu
  • Tao Cai
  • Junbo Liu
  • Shu CuiEmail author
  • Tao WuEmail author
Original Article
  • 44 Downloads

Abstract

Background

The current study aimed to carry out a comprehensive meta-analysis on the existing evidence to quantify and compare the oncological, surgical and functional outcomes following radical prostatectomy between TURP group and Non-TURP group.

Methods

A systematic literature search was conducted using EMBASE, PubMed and Cochrane databases to identify relevant studies published in English up to March 2019. A meta-analysis was conducted using Review Manager.

Results

There were 13 studies included in the present study. Our results suggest that TURP group demonstrates a significantly higher positive surgical margin rate, bladder neck reconstruction rate and overall complication rate compared with Non-TURP group (OR = 1.31, 95% CI 1.09–1.58, P = 0.004, I2 = 0%; OR = 14.36, 95% CI 2.93–70.45, P = 0.001, I2 = 81%; OR = 2.63, 95% CI 1.87–3.71, P < 0.00001, I2 = 0%); whereas TURP group demonstrates a significantly lower nerve sparing rate compared with Non-TURP group (OR = 0.30, 95% CI 0.22–0.43, P < 0.00001, I2 = 40%); the operation time, blood loss and 1-year urinary continence rate are same between TURP group and Non-TURP group (MD = 4.25, 95% CI − 0.13 to 8.63, P = 0.06, I2 = 34%; MD = 27.29, 95% CI − 10.31 to 64.90, P = 0.15, I2 = 39%; OR = 0.68, 95% CI 0.43–1.06, P = 0.09, I2 = 0%).

Conclusion

This meta-analysis demonstrates that Non-TURP group may have a great advantage over TURP group in terms of positive surgical margin rate, bladder neck reconstruction rate, overall complication rate and sparing rate. The operation time, blood loss and 1-year urinary continence rate are comparable between TURP group and Non-TURP group. Therefore, important information should be given to those patients at risk of prostate cancer that TURP procedure may increase perioperative complications in case of a following radical prostatectomy. In the meantime, our meta-analysis found that each of these four subgroups (RARP, LRP, ORP and RARP/ORP) has its own advantages or disadvantages in every pool results. So when radical prostatectomy is performed on patients with TURP history, the appropriate operation method should be selected as per the conditions of patients, doctors and hospitals.

Keywords

Radical prostatectomy Prostate cancer Transurethral resection of the prostate Meta-analysis 

Notes

Acknowledgements

This work was supported by the Natural Science Foundation of Sichuan Provincial Department of Education (16ZB0227), Scientific Research Foundation of Health and Family Planning Commission of Sichuan Province (17PJ155) and City of Nanchong Strategic Cooperation with Local Universities Foundation of technology (NSMC20170421, NSMC20170111, 18SXHZ0581, 18SXHZ0128).

Authors’ contributions

SC, TW: project development, public funding. XD, XXM, THH, TC, JBL: data collection. HL, XD: data analysis, manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

345_2019_2986_MOESM1_ESM.doc (108 kb)
Supplementary material 1 (DOC 108 kb)
345_2019_2986_MOESM2_ESM.doc (35 kb)
Supplementary material 2 (DOC 35 kb)
345_2019_2986_MOESM3_ESM.docx (18 kb)
Supplementary material 3 (DOCX 18 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyAffiliated Hospital of North Sichuan Medical CollegeNanchongPeople’s Republic of China
  2. 2.Department of DermatologyAffiliated Hospital of North Sichuan Medical CollegeNanchongPeople’s Republic of China
  3. 3.Department of Gastrointestinal SurgeryAffiliated Hospital of North Sichuan Medical CollegeNanchongPeople’s Republic of China

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