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

Bladder Cancer
22/06/2020

Sari Motlagh R, et al. BJU Int 2020 - Review.

ABSTRACT

OBJECTIVES: A simultaneous surgery for bladder cancer and benign prostatic hyperplasia (BPH) is not an unusual scenario. Theoretically, simultaneous transurethral resection of bladder tumor (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). We aimed to evaluate recurrence and progression risk after simultaneous endoscopic surgery of bladder cancer and BPH.

MATERIALS AND METHODS: We conducted a systematic review and meta-analysis to assess the risk of recurrence (i.e., whole bladder and/or BN/PU) and tumor progression as outcomes after a simultaneous endoscopic surgery of bladder tumor 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 randomized clinical trials (RCT) separately. Eight retrospective and three RCT studies were included to assess the BN/PU recurrence risk and the summarized risk ratios (RR) were 1.02 (95% confidence intervals (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 summarized RR were 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 summarized RR were 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 tumor and BPH, as compared to TURBT alone.