{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:54:28Z","timestamp":1791842068629,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Men with detrusor underactivity (DUA)\u00a0and concomitant bladder outlet obstruction (BOO)\u00a0due to benign prostatic enlargement (BPE)\u00a0may present poorer functional outcomes after surgical desobstruction. This study aimed to evaluate the safety and efficacy of BPE surgery in men with DUA compared with those with normal detrusor contractility (NC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This review was performed according to the 2020 PRISMA framework. A comprehensive literature search was performed until May 7, 2023, using MEDLINE, EMBASE, and Cochrane Database. No date limits were imposed. Only comparative studies were accepted. The primary endpoint was to assess if there was any difference in short\u2010 and long\u2010term functional outcomes after BPE surgery in men with DUA and NC. The secondary endpoint was to evaluate the differences in perioperative outcomes and postoperative complications between the two groups. Meta\u2010analysis was performed using Review Manager (RevMan) software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 5 prospective nonrandomized studies and 12 retrospective studies, including 1701 DUA and 1993 NC patients. Regarding surgical procedures, there were eight\u00a0TURP (transurethral resection of the prostate) studies, four\u00a0GreenLight PVP (photoselective vaporization of the prostate) studies, two\u00a0HoLEP (Holmium laser enucleation of the prostate) studies, one\u00a0GreenLight PVP\/HoLEP\u00a0study, one\u00a0Holmium laser incision of the prostate study, and one\u00a0study did not report the type of surgery. We did not find a statistically significant difference between the two groups in terms of perioperative outcomes, including postoperative catheterization time, hospitalization time, urinary retention, need to recatheterization, transfusion rate, or urinary tract infections. Also, we found no significant differences in long\u2010term complications, such as bladder neck stenosis or urethral stenosis. Posttreatment bladder recatheterization and retreatment rate for BPE regrowth could not be evaluated properly, because only one study reported these findings. When we analyzed functional outcomes at 3 months, those with NC had lower International Prostatic Symptom Score (IPSS),\u00a0lower quality\u2010of\u2010life (QoL) score, better maximum flow rate (Qmax), and lower post\u2010voiding residual (PVR)\u00a0of urine. These results were maintained at 6 months postoperatively, with exception of PVR that showed no difference. However, at 12 and more than 12 months the functional outcomes became similar regarding IPSS and QoL. There were few data about Qmax and PVR at longer follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this meta\u2010analysis, data suggest that BOO surgical treatment in patients with concomitant BPE and DUA appears to be safe. Despite patients with DUA may present worse functional outcomes in the short postoperative term compared with the NC population, IPSS and QoL scores become comparable again after a longer follow\u2010up period after surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.25336","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T20:17:39Z","timestamp":1701116259000},"page":"126-143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Functional and safety outcomes after benign prostatic enlargement surgeries in men with detrusor underactivity compared with normal detrusor contractility: Systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-9085","authenticated-orcid":false,"given":"Marcelo Langer","family":"Wroclawski","sequence":"first","affiliation":[{"name":"Department of Urology Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"},{"name":"Department of Urology Hospital Beneficencia Portuguesa de Sao Paulo S\u00e3o Paulo Brazil"},{"name":"Department of Urology Faculdade de Medicina do ABC Santo Andr\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6683-5797","authenticated-orcid":false,"given":"Lucas Seiti","family":"Takemura","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo Octaviano Duarte","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio Lobo","family":"Heldwein","sequence":"additional","affiliation":[{"name":"Department of Urology Universidade Federal de Santa Catarina Florianopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet","family":"Gauhar","sequence":"additional","affiliation":[{"name":"Department of Urology Ng Teng Fong General Hospital  Singapore"},{"name":"Department of Urology National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee Jean","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Urology National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5277-7511","authenticated-orcid":false,"given":"Yu Xi Terence","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Urology National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2342","authenticated-orcid":false,"given":"Jeremy Yuen\u2010Chun","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Surgery, S.H. 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