OBJECTIVES: To evaluate recurrence and progression risk after simultaneous endoscopic surgery of bladder cancer and benign prostatic hyperplasia (BPH), as simultaneous surgery is not an unusual scenario and theoretically simultaneous transurethral resection of bladder tumour (TURBT) and transurethral resection of the prostate (TURP) can lead to an increased risk of recurrence in the bladder neck and prostatic urethra (BN/PU). METHODS: We conducted a systematic review and meta-analysis to assess the risk of recurrence (i.e. whole bladder and/or BN/PU) and tumour progression as outcomes after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone. We queried PubMed and Web of Science database on 1 January 2020. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to the I2 statistic, respectively. RESULTS: Nine retrospective and three clinical trial studies were selected after considering inclusion and exclusion criteria. We conducted the meta-analysis on retrospective and randomised controlled trials (RCTs) separately. Eight retrospective and three RCT studies were included to assess the BN/PU recurrence risk and the summarised risk ratio (RR) was 1.02 (95% confidence interval [CI] 0.74-1.41) and 0.93 (95% CI 0.47-1.84), respectively. Five retrospective and two RCT studies were included to assess the progression risk and the summarised RR was 0.91 (95% CI 0.56-1.48) and 1.16 (95% CI 0.30-4.51), respectively. Eight retrospective and three RCT studies were included to assess the whole bladder recurrence risk and the summarised RR was 0.87 (95% CI 0.78-0.97) and 0.89 (95% CI 0.65-1.21), respectively. CONCLUSION: We did not observe any increased risk of total bladder recurrence, BN/PU recurrence, or progression after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone.

Cancer Prognostics and Health Outcomes Unit University of Montreal Health Center Montreal QC Canada

Department of Special Surgery Jordan University Hospital The University of Jordan Amman Jordan

Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Urology Ehime University Graduate School of Medicine Ehime Japan

Department of Urology Medical University of Vienna Vienna Austria

Department of Urology The Jikei University School of Medicine Tokyo Japan

Department of Urology University Hospital Frankfurt Frankfurt am Main Germany

Department of Urology University Hospital of Tours Tours France

Department of Urology University of Texas Southwestern Dallas TX USA

Department of Urology Weil Cornell Medical College New York NY USA

European Association of Urology Research Foundation Arnhem The Netherlands

Institute for Urology and Reproductive Health Sechenov University Moscow Russia

Karl Landsteiner Institute of Urology and Andrology Vienna Austria

King Fahad Specialist Hospital Dammam Saudi Arabia

King Faisal Medical City Abha Saudi Arabia

Zobrazit více v PubMed

Bryan RT, Collins SI, Daykin MC et al. Mechanisms of recurrence of Ta/T1 bladder cancer. Ann R Coll Surg Engl 2010; 92: 519–24 PubMed PMC

Sanli O, Dobruch J, Knowles MA et al. Bladder cancer. Nat Rev Dis Primer 2017; 3: 17022 PubMed

Ham WS, Kim WT, Jeon HJ, Lee DH, Choi YD. Long‐term outcome of simultaneous transurethral resection of bladder tumor and prostate in patients with nonmuscle invasive bladder tumor and bladder outlet obstruction. J Urol 2009; 181: 1594–8 PubMed

Tsivian A, Shtricker A, Sidi AA. Simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia: hazardous or a safe timesaver? J Urol 2003; 170: 2241–3 PubMed

Jaidane M, Bouicha T, Slama A et al. Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate: a comparative retrospective study. Urology 2010; 75: 1392–5 PubMed

Stang A. Critical evaluation of the Newcastle‐Ottawa scale for the assessment of the quality of nonrandomized studies in meta‐analyses. Eur J Epidemiol 2010; 25: 603–5 PubMed

Higgins JP, Altman DG, Gøtzsche PC et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928 PubMed PMC

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003; 327: 557–60 PubMed PMC

Dellabella M, Branchi A, Gasparri L, Claudini R, Castellani D. Oncological safety and quality of life in men undergoing simultaneous transurethral resection of bladder tumor and prostate: results from a randomized controlled trial. World J Urol 2018; 36: 1629–34 PubMed

Li Z, Hou R, Li J. The efficacy and safety of simultaneous transurethral GreenLight photoselective vaporization of bladder tumor and prostate in patients with bladder tumor and lower urinary tract symptoms. Int Urol Nephrol 2014; 46: 691–4 PubMed

Singh V, Sinha RJ, Sankhwar SN. Outcome of simultaneous transurethral resection of bladder tumor and transurethral resection of the prostate in comparison with the procedures in two separate sittings in patients with bladder tumor and urodynamically proven bladder outflow obstruction. J Endourol 2009; 23: 2007–11 PubMed

Ugurlu O, Gonulalan U, Adsan O, Kosan M, Oztekin V, Cetinkaya M. Effects of simultaneous transurethral resection of prostate and solitary bladder tumors smaller than 3 cm on oncologic results. Urology 2007; 70: 55–9 PubMed

Vicente J, Chéchile G, Pons R, Méndez G. Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate. Eur Urol 1988; 15: 40–2 PubMed

Laor E, Grabstald H, Whitmore WF. The influence of simultaneous resection of bladder tumors and prostate on the occurrence of prostatic urethral tumors. J Urol 1981; 126: 171–5 PubMed

Greene LF, Yalowitz PA. The advisability of concomitant transurethral excision of vesical neoplasm and prostatic hyperplasia. J Urol 1972; 107: 445–7 PubMed

Wang Y, Zhang Z, Shao J, Lü Y, Li X, Li R. Outcome of simultaneous thulium laser enucleation of bladder tumor and prostate in patients with non‐muscle invasive bladder tumor and benign prostatic hyperplasia: a matched‐pair comparison with a long‐term follow‐up. World J Urol 2020. [Online ahead of print]. DOI: 10.1007/s00345‐020‐03158‐3 PubMed

Park SH, Kim SI, Kim SJ. Effects of simultaneous transurethral resection of non‐muscle‐invasive bladder cancer and benign prostatic hyperplasia. Korean J Urol 2009; 50: 534–9

Professionals S‐O . EAU Guidelines: Non‐muscle‐invasive Bladder Cancer [Internet]. Uroweb. Available at: https://uroweb.org/guideline/non‐muscle‐invasive‐bladder‐cancer/#note_130. Accessed March 2020

Picozzi SC, Ricci C, Gaeta M et al. Is it oncologically safe performing simultaneous transurethral resection of the bladder and prostate? A meta‐analysis on 1,234 patients. Int Urol Nephrol 2012; 44: 1325–33 PubMed

Zhou L, Liang X, Zhang K. Assessment of the clinical efficacy of simultaneous transurethral resection of both bladder cancer and the prostate: a systematic review and meta‐analysis. Aging Male 2020; 1–12 PubMed

Palou J, Sylvester RJ, Faba OR et al. Female gender and carcinoma in situ in the prostatic urethra are prognostic factors for recurrence, progression, and disease‐specific mortality in T1G3 bladder cancer patients treated with bacillus Calmette‐Guérin. Eur Urol 2012; 62: 118–25 PubMed

Mungan MU, Canda AE, Tuzel E, Yorukoglu K, Kirkali Z. Risk factors for mucosal prostatic urethral involvement in superficial transitional cell carcinoma of the bladder. Eur Urol 2005; 48: 760–3 PubMed