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dc.contributor.authorBouza, Carmen 
dc.contributor.authorLopez-Cuadrado, Teresa 
dc.contributor.authorMagro, Angeles
dc.contributor.authorNavalpotro, Lourdes
dc.contributor.authorAmate, Jose Maria
dc.identifier.citationBMC Urol. 2006 Jun 21;6:14.es_ES
dc.description.abstractBACKGROUND: Benign prostatic hyperplasia (BPH) constitutes a major clinical problem. Minimally invasive therapies for the treatment of symptomatic BPH include Transurethral Needle Ablation (TUNA), but it is unclear what impact this technique has on the disease and its role among other currently available therapeutic options. The objective of this study is to ascertain the efficacy and safety of TUNA in the treatment of BPH. METHODS: Systematic review of the literature until January 2005 and meta-analysis of clinical studies assessing TUNA in symptomatic BPH. Studies were critically appraised. Estimates of effect were calculated according to the random-effects model. RESULTS: 35 studies (9 comparative, 26 non-comparative) were included. Although evidence was limited by methodological issues, the analysis of relevant outcomes indicates that while TUNA significantly improves BPH parameters with respect to baseline, it does not reach the same level of efficacy as TURP in respect to all subjective and objective variables. Further, its efficacy declines in the long-term with a rate of secondary-treatment significantly higher than of TURP [OR: 7.44 (2.47, 22.43)]. Conversely, TUNA seems to be a relatively safe technique and shows a lower rate of complications than TURP [OR:0.14 (0.05, 0.14)] with differences being particularly noteworthy in terms of postoperative bleeding and sexual disorders. Likewise, TUNA has fewer anesthetic requirements and generates a shorter hospital stay than TURP [WMD: -1.9 days (-2.75, -1.05)]. Scarce data and lack of replication of comparisons hinder the assessment of TUNA vs. other local therapies. No comparisons with medical treatment were found. CONCLUSION: The body of evidence on which TUNA has been introduced into clinical practice is of only moderate-low quality. Available evidence suggest that TUNA is a relatively effective and safe technique that may eventually prove to have a role in selected patients with symptomatic BPH. TUNA significantly improves BPH parameters with respect to baseline values, but it does not reach the same level of efficacy and long-lasting success as TURP. On the other hand, TUNA seems to be superior to TURP in terms of associated morbidity, anesthetic requirements and length of hospital stay. With respect to the role of TUNA vis-à-vis other minimally invasive therapies, the results of this review indicate that there are insufficient data to define this with any degree of accuracy. Overall cost-effectiveness and the role of TUNA versus medical treatment need further evaluation.es_ES
dc.description.sponsorshipThis study was commissioned by the HTA Programme on behalf of the Ministry of Health & Consumers Affairs and was partially supported by the Spanish National I+D Program (grant number SEC 2001–0138). C Bouza is the recipient of a contract from the Dirección General de Universidades e Investigación. Consejeria de Educación de la Comunidad de Madrid (02/0381/2002).es_ES
dc.publisherBioMed Centrales_ES
dc.relation.isversionofPublisher's versiones_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshProstatic Hyperplasia es_ES
dc.subject.meshQuality of Life es_ES
dc.subject.meshTreatment Outcome es_ES
dc.subject.meshUrodynamics es_ES
dc.subject.meshTransurethral Resection of Prostate es_ES
dc.titleSystematic review and meta-analysis of Transurethral Needle Ablation in symptomatic Benign Prostatic Hyperplasiaes_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderComunidad de Madrid
dc.contributor.funderMinisterio de Sanidad y Consumo (España)
dc.identifier.journalBMC urologyes_ES
dc.repisalud.centroISCIII::Agencia de Evaluación de Tecnologías Sanitariases_ES

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