The recurrence and progression risk after simultaneous endoscopic surgery of urothelial bladder tumour and benign prostatic hyperplasia: a systematic review and meta-analysis

Reza Sari Motlagh; Keiichiro Mori; Noriyoshi Miura; Fahad Quhal; Abdulmajeed Aydh; Ekaterina Laukhtina; Benjamin Pradere; Pierre I Karakiewicz; Dmitry V Enikeev; Marina Deuker; Shahrokh F Shariat

doi:10.1111/bju.15146

The recurrence and progression risk after simultaneous endoscopic surgery of urothelial bladder tumour and benign prostatic hyperplasia: a systematic review and meta-analysis

BJU Int. 2021 Feb;127(2):143-152. doi: 10.1111/bju.15146. Epub 2020 Aug 12.

Authors

Reza Sari Motlagh¹, Keiichiro Mori^{1

2}, Noriyoshi Miura^{1

3}, Fahad Quhal^{1

4}, Abdulmajeed Aydh^{1

5}, Ekaterina Laukhtina^{1

6}, Benjamin Pradere^{1

7}, Pierre I Karakiewicz⁸, Dmitry V Enikeev⁶, Marina Deuker^{8

9}, Shahrokh F Shariat^{1

6

10

11

12

13

14

15}

Affiliations

¹ Department of Urology, Medical University of Vienna, Vienna, Austria.
² Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
³ Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan.
⁴ King Fahad Specialist Hospital, Dammam, Saudi Arabia.
⁵ King Faisal Medical City, Abha, Saudi Arabia.
⁶ Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
⁷ Department of Urology, University Hospital of Tours, Tours, France.
⁸ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
⁹ Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
¹⁰ Department of Urology, Weil Cornell Medical College, New York, NY, USA.
¹¹ Department of Urology, University of Texas Southwestern, Dallas, TX, USA.
¹² Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
¹³ Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
¹⁴ Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
¹⁵ European Association of Urology Research Foundation, Arnhem, The Netherlands.

Abstract

Objectives: To evaluate recurrence and progression risk after simultaneous endoscopic surgery of bladder cancer and benign prostatic hyperplasia (BPH), as simultaneous surgery is not an unusual scenario and theoretically simultaneous transurethral resection of bladder tumour (TURBT) and transurethral resection of the prostate (TURP) can lead to an increased risk of recurrence in the bladder neck and prostatic urethra (BN/PU).

Methods: We conducted a systematic review and meta-analysis to assess the risk of recurrence (i.e. whole bladder and/or BN/PU) and tumour progression as outcomes after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone. We queried PubMed and Web of Science database on 1 January 2020. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to the I² statistic, respectively.

Results: Nine retrospective and three clinical trial studies were selected after considering inclusion and exclusion criteria. We conducted the meta-analysis on retrospective and randomised controlled trials (RCTs) separately. Eight retrospective and three RCT studies were included to assess the BN/PU recurrence risk and the summarised risk ratio (RR) was 1.02 (95% confidence interval [CI] 0.74-1.41) and 0.93 (95% CI 0.47-1.84), respectively. Five retrospective and two RCT studies were included to assess the progression risk and the summarised RR was 0.91 (95% CI 0.56-1.48) and 1.16 (95% CI 0.30-4.51), respectively. Eight retrospective and three RCT studies were included to assess the whole bladder recurrence risk and the summarised RR was 0.87 (95% CI 0.78-0.97) and 0.89 (95% CI 0.65-1.21), respectively.

Conclusion: We did not observe any increased risk of total bladder recurrence, BN/PU recurrence, or progression after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone.

Keywords: #BladderCancer; #blcsm; TURBT; TURP; benign prostatic hyperplasia; bladder cancer; endoscopic surgery; simultaneous surgery.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Cystectomy / adverse effects*
Humans
Male
Neoplasm Recurrence, Local / diagnosis*
Prostatic Hyperplasia / diagnosis
Prostatic Hyperplasia / surgery*
Transurethral Resection of Prostate / adverse effects*
Urinary Bladder / diagnostic imaging*
Urinary Bladder Neoplasms / diagnosis
Urinary Bladder Neoplasms / surgery*