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Table 6 TUNA vs. other minimally invasive therapies. Efficacy

From: Systematic review and meta-analysis of Transurethral Needle Ablation in symptomatic Benign Prostatic Hyperplasia

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

TUMT

Difference in means(% improvement)

TUNA vs. TUMT WMD (95% CI), P value

Symptom score

Pre-3 months

156 (76)

-9.3 (48%)

-5.2 (28%)

-4.1 (-5.02, -3.18), .00

Quality-of-life score

Pre-3 months

156 (76)

-2.3 (49%)

-1.7 (39%)

-0.6 (-0.75, -0.44), .00

Qmax (mL/s)

Pre- 3 months

156 (76)

1 (11%)

0.9 (12%)

0.1 (-0.47, 0.67), .73

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

WIT

Difference in means (% improvement)

TUNA vs. WIT

WMD (95% CI), P value

Qmax (ml/sec

Pre- 6 months

158 (37)

3.2 (41%)

1.8 (14%)

1.4 (-0.13, 2.93), .07

Pre- 2 years

158 (37)

4.9 (44%)

2.2 (18%)

2.7 (1.14, 4.26), .00

PVR (mL)

Pre- 6 months

158 (37)

-58.3 (62%)

-18.5 (25%)

-39.8 (-46.4, -33.2), .00

Pre- 2 years

158 (37)

-40.9 (54%)

-23.3 (49%)

-17.6 (-24, -11.2), .00

P det at Qmax (cm H 2 O)

Pre- 6 months

158 (37)

-22.52 (35%)

-17.5 (27%)

-5.02 (-9.36, -0.65), .02

Pre- 2 years

158 (37)

-28.56 (44%)

-15.7 (25%)

-12.9 (-17.4, -8.34), .00

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

ILC

Difference in means (% improvement)

TUNA vs. ILC

WMD (95% CI), P value

Symptom score

Pre- 3 months

156 (84)

-9.3 (48%)

-12.4 (64%)

3.1 (2.36, 3.84), .00

Quality-of-life score

Pre- 3 months

156 (84)

-2.3 (49%)

-2.5 (58%)

0.2 (0.06, 0.34), .00

Qmax (mL/s)

Pre- 3 months

156 (84)

1 (11%)

5 (53%)

-4 (-4.64, -3.36), .00

Pre- 6 months

158 (95)

3.2 (41%)

2.8 (30%)

0.4 (-0.15, 0.95), .15

Pre- 2 years

158 (95)

4.9 (44%)

3 (32%)

1.9 (1.27,2.52), .00

PVR (mL)

Pre- 3 months

156 (84)

-22.1 (26%)

-71.9 (72%)

49.8 (41.99, 57.60), .00

Pre- 6 months

158 (95)

-58 (62%)

-45 (45%)

-13 (-16.41, -10.2), .00

Pre- 2 years

158 (95)

-41 (54%)

-42 (42%)

1.3 (-2.07, 4.67), .45

P det at Qmax (cm H 2 O)

Pre- 6 months

158 (95)

-22.5 (35%)

-25.8 (38%)

3.28 (1.4, 5.16), .00

Pre- 2 years

158 (95)

-28.6 (44%)

-23 (34%)

-5.56 (-7.76, -3.36), .00

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

TUVP

Difference in means (% improvement)

TUNA vs. TUVP

WMD (95% CI), P value

Symptom score

Pre- 6 months

157 (32)

-9 (47%)

-13.1 (69%)

4.1 (2.38, 5.82), .00

Pre-1 year

157 (32)

-11.2 (58%)

-13.3 (70%)

2.1 (0.72, 3.48), .00

Pre- 2 years

157 (32)

-10 (52%)

-12.7 (66%)

2.7 (1.13, 4.27), .00

Qmax (mL/s)

Pre- 6 months

257,58 (69)a

3.42 (41%)

10.25 (108%)

-6.08 (-8.6, -3.5), .00

Pre- 1 year

157 (32)

2.6 (30%)

12.4 (132%)

-9.8 (-10.97, -8.63), .00

Pre- 2 years

257,58(69)b

2.76 (44%)

8.93 (97%)

-6.1 (-11.45, -0.67), .00

PVR (mL)

Pre- 6 months

257,58 (69)c

-57.26 (62%)

-61.84 (76%)

10.96 (0.26, 21.65), .04

Pre- 1 year

157 (32)

-53 (62%)

-51 (67%)

-2 (-16.15, 12.15), .78

Pre- 2 years

257,58 (69)b

-42.06 (54%)

-61.20 (74%)

10.87 (-20.54, 42.3), .49

P det at Qmax (cm H 2 O)

Pre- 6 months

158 (37)

-22.52 (35%)

-40 (53%)

17.48 (13.8, 21.2), .00

Pre- 2 years

158(37)

-28.56 (44%)

-35 (47%)

6.44 (2.32, 10.56), .00

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

VLAP

Difference in means (% improvement)

TUNA vs. VLAP

WMD (95% CI), P value

Symptom score

Pre- 6 months

157 (30)

-9 (47%)

-7.3 (37%)

-1.7 (-4.0,0.62), .15

Pre-1 year

157 (30)

-11.2 (58%)

-10.8 (55%)

-0.4 (-2.48, 1.68), .70

Pre- 2 years

157 (30)

-10 (52%)

-12.9 (65%)

2.9 (1.3, 4.5), .00

Qmax (mL/s)

Pre- 6 months

157 (30)

4.3 (41%)

8.6 (141%)

-4.3 (-6.17, -2.43),.00

Pre- 1 year

157 (30)

2.6 (30%)

7.8 (128%)

-5.2 (-6.3, -3.57), .00

Pre- 2 years

157 (30)

2.3 (44%)

5.6 (92%)

-3.3 (-4.7, -1.8), .00

PVR (mL)

Pre- 6 months

157 (30)

-44 (62%)

-63 (67%)

19 (1.90, 36.1), .02

Pre- 1 year

157 (30)

-53 (62%)

-64 (68%)

11 (-6.44, 28.44), .2

Pre- 2 years

157 (30)

-55 (54%)

-68 (72%)

13 (-5.6, 31.6), .17

Variable

No. studies (patients)

TUNA

Difference in means (% improvement)

HIFU

Difference in means (% improvement)

TUNA vs. HIFU

WMD (95% CI), P value

Symptom score

Pre- 6 months

157 (35)

-9 (47%)

-8.3 (56%)

-0.7 (-2.35, 0.95), .40

Pre- 1 year

157 (35)

-11.2 (58%)

-10.4 (71%)

-0.8 (-2.11, 0.51), .23

Pre- 2 years

157 (35)

-10 (52%)

-7 (48%)

-3.0 (-4.71, -1.29), .00

Qmax (mL/s)

Pre- 6 months

157 (35)

4.3 (41%)

3.9 (42%)

0.40 (-9.4, 1.74), .55

Pre- 1 year

157 (35)

2.6 (30%)

3.9 (42%)

-1.30 (-2.16, -0.44), .00

Pre- 2 years

157 (35)

2.3 (44%)

2 (22%)

0.30 (-0.52, 1.12), .47

PVR (mL)

Pre- 6 months

157 (35)

-44 (62%)

-48 (51%)

4.00(-10.44, 18.44), .58

Pre- 1 years

157 (35)

-53 (62%)

-45 (48%)

-8.00 (-22.44, 6.44), .27

Pre- 2 years

157 (35)

-55 (54%)

-36 (38%)

-19 (33.69, -4.31), .01

  1. Abbreviations. TUMT: Transurethral Microwave Thermotherapy. WIT: Water-induced Thermotherapy. ILC: Interstitial Laser Coagulation. TUVP: Transurethral Electrovaporization of the Prostate. VLAP: Visual Laser Ablation of the Prostate. HIFU: Transrectal High Intensity Focused Ultrasound.
  2. WMD: Weighted mean difference. Qmax: Maximum urinary flow rate. PVR: Post-void residual volume. Pdet at Qmax: Detrusor presures at peak flow rate.