[Laser treatment for benign prostatic hyperplasia. Proposal of assessment indicators]

Paz Valinas L, Queiro Verdes T
Record ID 32010000455
Spanish
Authors' objectives:

1. To undertake a systematic review of the efficacy and safety of different laser techniques versus TURP in the treatment of benign prostatic hyperplasia; and, 2. To draw up a quality-indicator proposal for assessing the results of the implementation of such techniques in clinical practice.

Authors' recommendations: The scientific evidence is very heterogeneous as regards methodological quality and variables studied.The laser techniques assessed in this systematic review show an efficacy equivalent to that of TURP in the relief of prostatic symptoms, as measured by IPSS, Qmax and PVR.By reference to the outcomes of incontinence and urinary retention, retrograde ejaculation, erectile function, percentage of reintervention and mortality, the safety of the latest laser techniques is comparable to that of TURP. Although the decreases in haemoglobin concentration and need for blood transfusion were equivalent in both techniques, the result was nonetheless favourable to lasers.The most recent laser techniques outperform TURP in terms of the variables of hospital stay and urinary catheterisation time. TURP, in contrast, proved superior to laser techniques in terms of intervention time.A cost study should be undertaken targeting the latest laser techniques and the standard treatment, TURP, to ascertain the cost-effectiveness ratio.For the most recent laser techniques, such as TmLRP, HPS 120 W and HiDi, more good quality studies are required to confirm the data supported by the studies published to date. A total of 19 quality indicators have been proposed. These must now be prioritised, agreed and validated with expert health professionals in order to establish the definitive quality indicators and standards.The number of indicators to be defined as the most relevant for assessing surgical treatment of BPH should be kept to a maximum of 15.
Details
Project Status: Completed
URL for project: http://www.sergas.es/docs/Avalia-t/avaliat200904-hiperplasia-prostata.pdf
Year Published: 2010
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Humans
  • Laser Therapy
  • Prostatectomy
  • Prostatic Hyperplasia
  • Transurethral Resection of Prostate
Contact
Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)
Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;
Contact Name: avalia-t@sergas.es
Contact Email: avalia-t@sergas.es
Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.