Summary of findings 2. Quality of life ‐ short term.
Minimally invasive treatments versus transurethral resection of the prostate | ||||
Patient or population: men with moderate to severe lower urinary symptoms due to benign prostatic hyperplasia Interventions: minimally invasive treatments Comparator (reference): transurethral resection of the prostate Setting: hospital procedure – outpatient follow‐up | ||||
Outcome: Quality of life Measured by: IPSS QoL range 0‐6 (lower scores indicate a fewer impact on the quality of life) Follow‐up: 3 to 12 months | ||||
13 studies 1469 participants |
Anticipated absolute effect (95% CI) * | Certainty of the evidence | Ranking (SUCRA) ** | |
With TURP | With a minimally invasive procedure | |||
PUL (UroLift) (mixed estimate) |
Mean score in the included studies: 2.09 (range 0.9 to 3.26)a | 0.06 higher (1.17 lower to 1.30 higher) |
⊕⊕⊝⊝ LOW b c |
2.8 (70.3%) |
PAE (mixed estimate) |
0.09 higher (0.57 lower to 0.75 higher) |
⊕⊕⊝⊝ LOW b d |
2.9 (68.1%) |
|
CRFWVT (Rezūm) (indirect estimate) |
0.37 higher (1.45 lower to 2.20 higher) |
⊕⊕⊝⊝ LOW b c |
3.6 (56.3%) |
|
TUMT (mixed estimate) |
0.65 higher (0.48 lower to 1.78 higher) |
⊕⊕⊝⊝ LOW b e |
4.5 (42.2%) |
|
TIND (indirect estimate) |
0.87 higher (1.04 lower to 2.79 higher) |
⊕⊕⊝⊝ LOW b c |
5.0 (33.4%) |
|
CI: confidence interval; CRFWVT: convective radiofrequency water vapor therapy; IPSS: International Prostate Symptom Score; MD: mean difference; QoL: quality of life; PAE: prostatic arterial embolization; PUL: prostatic urethral lift; SUCRA: surface under the cumulative ranking curve; TIND: temporary implantable nitinol device; TUMT: transurethral microwave thermotherapy; TURP: transurethral resection of prostate. Network meta‐analysis summary of findings table definitions: * Estimates are reported as mean difference and CI. ** Rank statistics is defined as the probability that a treatment out of n treatments in a network meta‐analysis is the best, the second, the third, and so on until the least effective treatment. Between brackets are the surface under the curve (SUCRA) estimates. | ||||
GRADE Working Group grades of evidence (or certainty of the evidence). High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
aTURP was the highest‐ranked intervention for this outcome with a mean rank of 2.5 (SUCRA 75.7%)
bDowngraded by one level due to major concerns on within‐study bias: nearly all studies contributing to this estimate had an overall high risk of bias.
cDowngraded by one level due to major concerns on imprecision: the estimate crosses the threshold for minimally important difference (one point for IPSS‐QoL) and the line of no effect.
dDowngraded by one level due to major concerns on inconsistency (heterogeneity): the prediction interval crosses the threshold for minimally important difference (one point for IPSS‐QoL) and the line of no effect.
eDowngraded by one level due to some concerns regarding inconsistency (heterogeneity) and imprecision: the estimate and the prediction interval crosses the threshold for minimally important difference (one point for IPSS‐QoL)