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. 2021 Jul 15;2021(7):CD013656. doi: 10.1002/14651858.CD013656.pub2

Zhu 2018.

Study characteristics
Methods Study design: parallel randomized controlled study
Dates when study was conducted: January to October 2016
Setting: single center
Country:China
Participants Inclusion criteria:men with:
  • Comprehensive diagnosis of BPH through ultrasound prostate examination, digital rectal examination, IPSS, etc

  • No absolute contraindication for surgery

  • No previous history of surgery; not taking 5‐alpha reductase inhibitors


Exclusion criteria: men with:
  • Severe liver and kidney disorders, severe urethral strictures

  • Prostate tumors, bladder neck stenosis, urinary infections and neurogenic bladder

  • Severe heart and brain diseases, coagulopathy, systemic organ low functionality


Total number of participants randomly assigned: 40
Group A (PAE)
  • Number of all participants randomly assigned: 20

  • Age (years): 61.1 ± 4.4

  • Prostate volume (mL): 81.21 ± 6.34

  • PSA (ng/mL): 8.97 ± 3.04

  • IPSS: median 25.63 ± 4.28

  • Qmax (mL/s): 8.25 ± 2.36


Group B (Sham)
  • Number of all participants randomly assigned: 20

  • Age (years): 62.4 ± 4.9

  • Prostate volume (mL): 82.09 ± 6.47

  • PSA (ng/mL): 8.95 ± 2.86

  • IPSS: median 26.22 ± 4.35

  • Qmax (mL/s): 8.47 ± 2.39

Interventions Group A: PAE
Group B: TURP (not defined)
Follow‐up: 12 months
Outcomes Urologic symptom scores
How measured: IPSS
Time points measured: at baseline, 3, 6, and 12 months
Time points reported: at baseline, 3, 6, and 12 months
Subgroups: none
Quality of Life
How measured: IPSS‐QoL
Time points measured: at baseline, 3, 6, and 12 months
Time points reported: at baseline, 3, 6, and 12 months
Subgroups: none
Acute urinary retention
How measured: not reported
Time points measured: within 12 months
Time points reported: likely cumulative incidence.
Subgroups: none
Relevant outcomes not reported in this study
  • Major and minor adverse events

  • Ejaculatory dysfunction

  • Erectile function

  • Retreatment

  • Indwelling urinary catheter

Funding sources Not available
Declarations of interest Not available
Notes Protocol: not available
Language of publication: Chinese
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Judgement: random number table method.
Allocation concealment (selection bias) Unclear risk Judgement: not described.
Blinding of participants and personnel (performance bias)
Subjective outcomes High risk Judgement: not described; blinding highly unlikely to have taken place.
Blinding of outcome assessment (detection bias)
Subjective outcomes High risk Judgement: not described; blinding highly unlikely to have taken place.
Blinding of outcome assessment (detection bias)
Objective outcomes Low risk Judgement: objective outcomes are likely not affected by lack of blinding.
Incomplete outcome data (attrition bias)
Urologic symptom scores/Quality of life Low risk Judgement: all randomized participants were included in the analysis (short term).
Incomplete outcome data (attrition bias)
Acute urinary retention Low risk Judgement: all randomized participants were included in the analysis (short term).
Selective reporting (reporting bias) Unclear risk Judgement: study outcomes were well pre‐defined and described, but protocol was not found.
Other bias Low risk Judgement: not detected.

BPH: benign prostatic hyperplasia; ICS male IS‐SF: International Continence Society short‐form male questionnaire; IIEF‐15: International index of erectile function; IPSS: International Prostate Symptom Score; MSHQ‐EJD; Male sexual health questionnaire for ejaculatory dysfunction; NA: not available; NR: not reported; OAB‐q SF: Overactive bladder questionnaire short form; PGI‐I: Patient Global Impression of Improvement; PSA: prostate specific antigen; PUL: prostatic urethral lift; PVR: post‐void residual volume; Qmax: maximum flow rate; QoL: quality of life; SD: standard deviation; SF‐6D: Short‐Form Six‐Dimension; SF‐12: 12‐item Short‐Form Health Survey; TURP: transurethral resection of prostate; VAS: visual analogue scale.