Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Men with lower urinary tract symptoms secondary to benign prostatic obstruction
Intervention: Bipolar transurethral resection of the prostate (BTURP)
Comparison: Monopolar transurethral resection of the prostate (MTURP)
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Urological symptoms at 12 months | Favours intervention | Moderate |
Bother at 12 months | No statistically significant difference | Moderate |
Transurethral resection (TUR) syndrome | Favours intervention | Moderate |
Urinary incontinence at 12 months | No statistically significant difference | Low |
Blood transfusion | Favours intervention | Moderate |
Re‐TURP | No statistically significant difference | Low |
Erectile function at 12 months | No statistically significant difference | Moderate |
Note The overall evidence rating in this table is based upon the primary outcomes as stated in the Cochrane review underpinning this Cochrane Clinical Answer (CCA) and the statistically significant reduction in bleeding requiring blood transfusion with BTURP (on average 12 vs 29 per 1000 men). The Cochrane review also notes that BTURP has a more favourable perioperative safety profile when compared with MTURP due to its potential ability to reduce TUR syndrome events and the need for blood transfusion. It also notes that due to the uncertainty of the evidence for urinary incontinence at 12 months and re-TURP, further research is required to properly assess these outcomes.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How do alpha‐blockers compare for treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia?
- How do phosphodiesterase inhibitors compare with other drug treatments for people with lower urinary tract symptoms consistent with benign prostatic hyperplasia?
- How do oral anticholinergic drugs compare with placebo for adults with overactive bladder syndrome?
- For men undergoing transurethral resection of the prostate (TURP), how do urodynamic studies before TURP affect outcomes?
- How does bipolar compare with monopolar transurethral resection of the prostate for men with lower urinary tract symptoms secondary to benign prostatic obstruction?
- How does naftopidil compare with tamsulosin or silodosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia (BPH)?
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