What question did this study set out to answer?

The study aims to evaluate the effectiveness and safety of endourological surgery for men with benign prostatic hyperplasia and related overactive bladder symptoms.

March 29, 2026Open Access

Efficacy and Safety of Endourological Surgery for Managing Overactive Bladder Symptoms in Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Key Points

The study aims to evaluate the effectiveness and safety of endourological surgery for men with benign prostatic hyperplasia and related overactive bladder symptoms.
Systematic literature search across multiple databases including PubMed and MEDLINE.
Assessment of complication rates using the Cochran-Mantel-Haenszel Method.
Analysis of storage symptoms measured by International Prostate Symptom Score at various postoperative intervals.
At 6 months, the OAB group showed higher storage symptom scores compared to the No OAB group.
No significant differences were noted in total-IPSS scores between groups at 3 and 6 months.
The No OAB group demonstrated significantly better outcomes in total-IPSS scores at 12 months.

Abstract

Purpose: To systematically review the outcomes of endoscopic surgery in men with benign prostatic hyperplasia (BPH) associated with preoperative overactive bladder (OAB) symptoms.Methods: Literature search was conducted on 12th May 2025 including PubMed, MEDLINE, Embase, and Scopus database. Complication rates were assessed using the Cochran-Mantel-Haenszel Method with the random effect model and reported as odds ratio, 95% confidence interval (CI), and P-values. Analyses were 2-tailed and the significance was set at P<0.05. Continuous variables were pooled using the inverse variance of the mean difference with a random effect, 95% CI, and P-values.Results: Thirteen studies were included. Overall, there were 1,436 patients, with 672 in the OAB group and 820 patients in the No OAB group. At 6 months postoperatively, the storage symptoms - International Prostate Symptom Score (IPSS) favored the OAB group (mean difference MD, 1.06; 95% CI, 0.18–1.95; P=0.02); however, changes at 3 and 6 months demonstrated no significant differences. Total-IPSS remained comparable between groups at 3 and 6 months, whereas at 12 months, the No OAB group exhibited significantly better outcomes (MD, 3.66; 95% CI, 1.87–5.45; P<0.0001). The quality-of-life (QoL) index shows no significant difference at 3 months, though HoLEP (holmium laser enucleation of the prostate) favored the OAB group at 6 months (MD, -0.36; 95% CI, -0.62 to -0.10; P=0.006), while overall changes beyond this period favored the No OAB group (MD, -0.61; 95% CI, -1.18 to -0.05; P=0.03). Urge urinary incontinence and the need for postoperative anticholinergic therapy did not differ significantly between groups at any time.Conclusions: This meta-analysis reveals that BPH patients with preoperative OAB experienced persistently higher postoperative storage symptoms despite comparable overall symptom improvement, with a more pronounced QoL enhancement over time. These findings emphasize the need for comprehensive preoperative assessment to guide patient counseling, refine surgical expectations, and improve postoperative management.

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Cite This Study

Giulioni et al. (Fri,) studied this question.

synapsesocial.com/papers/69c8c336de0f0f753b39de89 https://doi.org/https://doi.org/10.5213/inj.2550188.094

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