The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials.
OBJECTIVE
Transurethral incision of the prostate gland (TUIP) is perceived as a less morbid surgical alternative to standard transurethral resection of the prostate gland (TURP) for treatment of symptomatic mild to moderate benign prostate enlargement (BPE). We aimed to evaluate comparative clinical effectiveness of the two procedures.


METHODS
Systematic review and meta-analysis of short- and long-term data from randomised controlled trials comparing TUIP with TURP.


RESULTS
This review considered data from 795 randomised participants across 10 RCTs of moderate to poor quality 8 of which stated an upper limit for prostate size. No difference in the degree of symptomatic improvement was seen between the two procedures. Improvement in peak urine flow rate was lower for TUIP compared to TURP whilst the rate of blood transfusion and TUR syndrome was higher after TURP. Urinary retention, urinary tract infection, strictures and incontinence did not differ between the two approaches, although clinically important differences could not be ruled-out. TUIP was associated with a shorter duration of operation and length of hospital stay but a higher re-operation rate.


CONCLUSIONS
TUIP and TURP appear to offer equivalent symptomatic improvement for men with mild to moderate BPE. Choosing TUIP involves a trade-off between the lower risk of peri-operative morbidity and the higher risk of subsequent re-operation.
Lourenco
Tania
T
Health Services Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK. tania.lourenco@abdn.ac.uk
Shaw
Matthew
M
Fraser
Cynthia
C
MacLennan
Graeme
G
N'Dow
James
J
Pickard
Robert
R
D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome