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Results of a national survey”" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "310" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario a “Residencia de urología y formación en trasplante renal. Resultados de una encuesta a nivel nacional”" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O. Rodríguez Faba" "autores" => array:1 [ 0 => array:2 [ "nombre" => "O." 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Sánchez-Gómez, M. Polo-deSantos, F. Gómez-Sancha, S. Luengo-Matos" "autores" => array:4 [ 0 => array:4 [ "nombre" => "L.M." "apellidos" => "Sánchez-Gómez" "email" => array:1 [ 0 => "luism.sanchez@isciii.es" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Polo-deSantos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "F." 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"apellidos" => "Luengo-Matos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Agencia de Evaluación de Tecnologías Sanitarias (AETS), Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP), Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Instituto de Cirugía Urológica Avanzada, Clínica CEMTRO, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectividad y seguridad del sistema Urolift<span class="elsevierStyleSup">®</span> para el tratamiento de los síntomas de la hiperplasia benigna de próstata: revisión sistemática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1616 "Ancho" => 1659 "Tamanyo" => 129385 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Flowchart of the publications included in the study.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Benign prostatic hyperplasia (BPH) is one of the most prevalent diseases in older men and its importance has increased due to population aging. The prevalence increases with age, presenting histological criteria in more than 50% of men over 50 years and in 90% of those over 90 years.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1,2</span></a> BPH occurs with lower urinary tract symptoms (LUTS) that may be of emptying or storage. Voiding symptoms appear more frequently and respond to a static component by narrowing of the urethral lumen and a dynamic component by altering the tone of the muscle fibers due to enlargement of the prostate.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">3–5</span></a> The prevalence of LUTS in Europe varies with age, with a range that varies from 14% in the fourth decade to more than 40% from the sixth decade, the total prevalence of LUTS being 30%.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Since BPH and its treatment have a negative impact on quality of life and sexual function,<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">7</span></a> the treatment of BPH should be directed to reduce symptoms, improve the quality of life, and prevent the occurrence of complications.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">2,8–10</span></a> There are three treatment options according to the severity of the symptoms: watchful waiting, drug therapy, and surgical treatment.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a> Currently, the standard treatment is transurethral resection of the prostate, although there are other options such as lasers, which while they are less invasive, they involve certain risks like impaired sexual function. Therefore, there is interest in having therapeutic alternatives more efficient than drug therapy without assuming the risks associated with surgical treatment.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The Urolift<span class="elsevierStyleSup">®</span> system emerges as a technology that allows for minimally invasive treatment of LUTS secondary to BPH. It aims to increase the size of the prostatic urethra, retracting the prostate lobes without incisions, surgical resection, or thermal damage on the prostate. The system has two components: a distribution device and permanent implants that keep the prostate lobes retracted and open the urethra.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a> The technique can be performed under local anesthesia and the operative time is short.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The objective of this review is to evaluate the effectiveness and safety of the Urolift<span class="elsevierStyleSup">®</span> system for treating the symptoms of BPH.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">A systematic review of the scientific literature was conducted. The studies were identified by a comprehensive search of the scientific literature in MEDLINE databases (PubMed), The Cochrane Library, and databases of the CRD (Centre for Reviews and Dissemination, University of York, U.K.). Searches in other databases such as Clinicaltrials and EuroScan were performed. Various search strategies were designed to identify studies using free and controlled terminology combining keywords prostate or prostatic, urethral lift, urolift, and prostatic urethral lifting. We also searched online at web sites of Scientific Societies and Agencies for Health Technology Assessment, of national and international levels. Finally, a manual review of the bibliographic references of the documents found was performed.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study selection was performed until March 3, 2014 unrestricted by date of publication. Any design study, published in English, Spanish or French, with 2 or more BPH patients undergoing treatment of LUTS by the Urolift<span class="elsevierStyleSup">®</span> system, was included. Duplicate or outdated studies were excluded by subsequent ones at the same institution, narrative reviews, letters to the editor, commentaries, editorials, and studies of a case.</p><p id="par0035" class="elsevierStylePara elsevierViewall">As outcome measures, effectiveness indicators were collected: LUTS measured by the International Prostate Symptom Score questionnaire, Benign Prostatic Hyperplasia Impact Index (BPHII), maximum urinary flow (<span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>), and postvoid residual volume (PVR); symptoms of sexual function measured by the Sexual Health Inventory for Men (SHIM) and Male Sexual Health Questionnaire or Ejaculatory Dysfunction (MHSQ-EjD); and quality of life measured by QoL. Security indicators were also collected by recording adverse events.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Identification, selection and review of studies, as well as data extraction, were performed thoroughly and independently by two reviewers. Disagreements were resolved by consensus or in collaboration with another member of the research team. The quality of evidence was assessed independently by two researchers according to the scale of the Centre for Evidence Based Medicine in Oxford for treatment studies. Tables of evidence of studies that included information on general characteristics of the studies, patient characteristics, and outcome measures in relation to the effectiveness and safety of the procedure were made.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">A total of 26 articles and 2 documents from the National Institute for Health and Care Excellence (NICE)<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a> were identified. After reading the title and abstract, 3 studies were excluded for not meeting the inclusion criteria. After a thorough reading of the 25 papers that initially met the inclusion/exclusion criteria, 18 publications were excluded<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">11–28</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), 7 articles<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">29–35</span></a> finally being selected, of which 5 were case series<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">29,32–35</span></a> and one was a randomized clinical trial (LIFT trial) published in 2 journals with different outcome measures, one for urinary tract symptoms<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">31</span></a> and the other one for symptoms of sexual function.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">30</span></a> The flowchart of included and excluded studies is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Case series provide a level of evidence 4 (recommendation grade C) and the LIFT trial has a level of evidence 2B (recommendation grade B) of the scale of the Center for Evidence Based Medicine in Oxford for treatment studies (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The mean age of the patients included ranges from 65 to 74.3 years, with a mean prostate volume that goes from 41<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span> to 55<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span>. The type of anesthesia used is different, and it can be local, spinal, or general. The average number of Urolift<span class="elsevierStyleSup">®</span> implants ranges from 3.7 to 5.5 and the average hospital stay is less than one day. The maximum time of follow-up of studies was 12 months, except for a study with a follow-up of 24 months<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> and 2 with a follow-up of one month.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">29,35</span></a><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the characteristics of the included studies.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Effectiveness results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The results for LUTS found in the studies are shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>:</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> shows an improvement of 11 points (50% of improvement) in the IPSS in the group treated with Urolift<span class="elsevierStyleSup">®</span> (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>140) vs. an improvement of 5.9 points (24% improvement) in the control group (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>66) at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003). The follow-up of 12 months performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows an improvement of 49%. In the follow-up of 12 months, the studies<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30–34</span></a> found an improvement ranging from 41.8% of improvement<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> to 52%.<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> One month after the treatment, the percentage of improvement was 45.8%<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> and 47.5%.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">For the BPHII, the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> describes an improvement of 3.9 points (56% improvement) in the treatment group with Urolift<span class="elsevierStyleSup">®</span> vs. an improvement of 2.1 points (30% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). The follow-up at 12 months performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows an improvement of 59%. The remaining studies collect a percentage of improvement in the BPHII score ranging from 40.5%<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> to 62%.<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Regarding <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> (ml/s), the LIFT trial improved<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> has an improvement of 5.40<span class="elsevierStyleHsp" style=""></span>ml/s (53% improvement) in the treatment group with Urolift<span class="elsevierStyleSup">®</span> vs. an improvement of 1.98<span class="elsevierStyleHsp" style=""></span>ml/s (24.9% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.005). The follow-up at 12 months performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows an improvement of 59%. The other studies show a percentage of improvement that ranges from 38%<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> to 63.9%.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> describes an impovement in PVR of 9.7<span class="elsevierStyleHsp" style=""></span>ml (11.3% improvement) in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. an improvement of 22<span class="elsevierStyleHsp" style=""></span>ml (26.5% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.306). The follow-up at 12 months made only on patients in the treatment group with Urolift<span class="elsevierStyleSup">®</span> shows an improvement of 18%. The study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> shows an improvement of 63% at 24 months of treatment and the one by McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> an improvement of 3% at 12 months of treatment.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The results found for symptoms of sexual function in studies appear in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>:</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">The LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> finds in SHIM/IIEF5 an improvement of 0.1 points (0.75% improvement) in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. a 1.5-point improvement (10.9% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.139). The follow-up at 12 months performed only on patients in the treatment group with Urolift<span class="elsevierStyleSup">®</span> shows an improvement of 2.2%. The study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> shows an improvement of 7% at 24 months. One month after treatment, an improvement of 23.5%<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> and 2.3%<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> is described.</p><p id="par0180" class="elsevierStylePara elsevierViewall">For MHSQ-EjD (items 1–3), the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> describes an improvement of 2.2 points (25.3% improvement) in the group treated with Urolift<span class="elsevierStyleSup">®</span> versus a 1.7-point improvement (19.3% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.283). The 12-month follow-up conducted to patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows a 14% improvement. The study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> shows an 11% improvement at 24 months. One month after treatment, 63.6%<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> and 18.6% improvement is described.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">For MHSQ-EjD (item 4), the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> describes a worsening of 0.8 points (33.3% worsening) in the group treated with Urolift<span class="elsevierStyleSup">®</span> compared to a worsening of 0.7 points (31.8% worsening) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.595). The follow-up at 12 months for patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows a 40% improvement in the MHSQ-EjD4. The study by Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> study shows a 56.3% improvement after 1 month of treatment. Neither the study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> at 24 months of treatment or the study by Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> after 1 month of treatment described an improvement in item 4 of the MHSQ-EjD.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The results found in studies for QoL are shown in <a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>, the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> describing an improvement of 2.2 points (47.8% improvement) in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. an improvement of one point (21.2% improvement) in the control group at 3 months of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). The follow-up at 12 months conducted on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> shows an improvement in the QoL of 51%. The study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> shows an improvement in the QoL of 48% at 24 months of treatment, the one by McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> 53% at 12 months of treatment, and the one by Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> 43.8% after a month of treatment.</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Safety results</span><p id="par0110" class="elsevierStylePara elsevierViewall">The main adverse effects reported in the studies were dysuria, hematuria, irritative symptoms, urinary retention, symptoms of urgency, urinary tract infection, and orchitis. All events were classified as mild and most resolved within 2 weeks after treatment.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">29–31,33,34</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The results found in the studies are listed in <a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a>; dysuria is described in the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> in 34.3% of patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. 16.7% in the control group. The study by Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> shows 70% of patients with dysuria, the one by Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> 73%, and that by McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> 25%. Hematuria was found in the LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> trial in 25.7% of patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. 4.5% in the control group. The study by Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> shows 30% of patients with hematuria, the one by Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> 78%, and that by McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> 16%. 40% of patients in the study by Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> reported irritative symptoms. Urinary retention is described in the LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> trial in 0.7% of patients in the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. 1.5% in the control group. These symptoms occur in 10% of patients in the study by Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a>, in 6% of the study by Shore,<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> and in 3% of the study by McNicolas.<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> UTIs appear in the LIFT trial<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> in 3% of patients of the group treated with Urolift<span class="elsevierStyleSup">®</span> vs. 2% in the control group. The study by Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> decribes 12.5% of patients with UTI and the one by McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> 3%. The occurrence of orchitis is described in 5% of patients in the study by Garrido,<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> 3% in the study by McNicolas,<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> and in 1.5% in the study by Chin.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a></p><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The complications associated with surgical treatment and lack of adherence to medical treatment were important stimuli for the search of less invasive therapeutic procedures for patients with BPH.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">22</span></a> The Urolift<span class="elsevierStyleSup">®</span> system emerges as a new therapeutic alternative that acts mechanically separating the prostatic lobes, thus avoiding the risks associated with surgery.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">11,34</span></a> In this review, we found 6 studies evaluating the effectiveness and safety of the Urolift<span class="elsevierStyleSup">®</span> system for the treatment of symptoms associated with BPH. Of these, only one study is a randomized clinical trial,<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> and the rest are case series, so we can say that the quality of the evidence found is low.</p><p id="par0125" class="elsevierStylePara elsevierViewall">According to some authors,<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> patients with a prostate volume between 20 and 50<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span> are those that offer better responses to treatment with Urolift<span class="elsevierStyleSup">®</span>. Studies show that patients treated with Urolift<span class="elsevierStyleSup">®</span> have a mean prostate volume ranging from 41 to 55<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span>. However, two studies included patients with a mean prostate volume higher than 50<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span> and show good results after treatment.<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">33,35</span></a> Operative time is short, although we found great variability among studies, possibly due to the different way of collecting information, either from the entrance of the patient to the operating room or the treatment time itself. Only two studies report the average hospital stay, and a study points out the absence of hospital stay in the intervention. We believe that given the characteristics and speed of this technology, the average hospital stay is not a variable to consider, as it could be carried out on an outpatient basis. In the LIFT trial,<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> more than half of the patients were treated with local anesthesia, demonstrating the feasibility of this type of anesthesia to conduct the surgery. The average number of implants or sutures per patient ranges between 3.7 and 5.5 coinciding with what was reported in the scientific literature that maintains that the average number of implants is usually 4.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Regarding the Urolift<span class="elsevierStyleSup">®</span> effectiveness, all studies show improvement of LUTS, particularly in subjective scales. Only the LIFT trial at 3 months of follow-up shows that the PVR improves more in the control group than in the group treated with Urolift<span class="elsevierStyleSup">®</span>. Four studies analyze the results of treatment in relation to sexual function finding improvement of symptoms in the three scales used, but two studies<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">33,35</span></a> found no improvement in the MHSQ-EjD4 scale.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Regarding the quality of life, we found 4 studies analyzing this variable, although they did not specify the scale used. The studies show a significant improvement, which in the LIFT trial is statistically significant compared to the control group. The NICE documents indicate that some patients may prefer Urolift<span class="elsevierStyleSup">®</span> treatment to other treatment options with increased risk of sexual dysfunction, and also to long-term drug treatment.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a> However, this system is indicated only for certain patients, especially patients with mild to moderate symptoms and who wish to preserve sexual function, so it does not seem to get to replace TURP.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">22</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">As for the safety of the procedure, studies show that there are no significant side effects associated with this technology. The most common side effect is transient dysuria which occurs in 70% of cases of the study by Garrido.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> However, the symptoms associated with the intervention are mild, easing in most cases in one or two weeks.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">31,33</span></a> Some authors inform that nearly half of the patients do not require catheterization after surgery and among those who need it, in 75% of cases the catheter is removed the day after surgery.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> It is considered that a suitable technique for carrying out the procedure could reduce adverse effects such as dysuria and hematuria and improve the effectiveness of the treatment.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">16</span></a> As the scientific literature points out, no cases of impaired sexual function are collected after Urolift<span class="elsevierStyleSup">®</span> treatment, which is considered one of the most important advantages of the procedure.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">31,33</span></a> Regarding the safety of implants, there have been cystoscopic long-term examinations and the biocompatibility and no incrustation in the prostatic urethra have been checked.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">31</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The follow-up time of patients is short. Only one study<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> has follow-up data at two years. The LIFT trial shows comparative data only at 3 months. Therefore, we could say that the effectiveness and safety of the procedure is short/medium term, so far not having long-term results. In the evolution of patients, only some authors collect additional treatments performed in patients treated with Urolift<span class="elsevierStyleSup">®</span>. Chin et al. found that 20% of patients receive additional treatment in a follow-up period of two years.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> For the time being, the duration of improvement in symptoms is unknown. The NICE documents consider it is likely that this technology does not provide permanent relief of symptoms.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Among the possible limitations of this review we can find, besides the design of the studies, the small number of cases, which is important when evaluating the results. Moreover, some authors do not detail inclusion and exclusion criteria and there is heterogeneity in the studies found. Patients are not homogeneous, there may be differences in the severity of symptoms, or associated drug treatments. Furthermore, although it has not been long since it started being used, the technique has been changing.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> The study by Woo<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a> describes the evolution of the device and the technique of performing the procedure. According to the authors, the reduction of a 25Fr system to a 20Fr one made it possible to perform the treatment without dilating the urethra, but it probably increased variability in the response. There is also a learning curve in the placement of implants.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">20</span></a> Some authors consider it necessary to perform at least 5 treatments with Urolift<span class="elsevierStyleSup">®</span> to ensure that the technique of implant placement is optimal.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> In connection with the collection of outcome variables, it is important to highlight the homogeneity in the studies, using recognized and validated LUTS and sexual function scales. However, some authors suggest that patients may be reluctant to answer questions related to sexual function or activity.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">There is agreement in the scientific literature on the positive results of Urolift<span class="elsevierStyleSup">®</span> treatment and the need to continue research on the procedure. The NICE recommends the research and suggests collecting cases of all patients treated.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a> According to these documents, it is necessary to pay particular attention to the criteria for selection of patients and evaluate the effectiveness of the procedure on symptoms, quality of life, duration of the benefit (since the long-term results are unknown), and the need of reoperation. Besides, all the complications should be recorded.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Currently, there are 2 clinical trials underway with completion scheduled for late 2014 and 2018, respectively and that could provide with new evidence on the Urolift<span class="elsevierStyleSup">®</span> system,<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12,13</span></a> BPH-6: A UroLift<span class="elsevierStyleSup">®</span> System PostMarket Multi-Center Randomized Study (<a href="ctgov:NCT01533038">NCT01533038</a>) and LOCAL Study: UroLift System TOlerability and ReCovery When Administering Local Anesthesia (<a href="ctgov:NCT01876706">NCT01876706</a>).</p><p id="par0165" class="elsevierStylePara elsevierViewall">In this review, we found no economic studies evaluating this technology compared to other alternatives. However, the cost per implant seems to be high, so it would be very interesting to conduct studies of cost-effectiveness.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Although the quality of the available evidence is low, we can conclude that the Urolift<span class="elsevierStyleSup">®</span> system is an interesting therapeutic option for selected patients with symptoms associated with BPH. The available short- and medium-term results show that the technique contributes to the improvement of lower urinary tract symptoms, without relevant side effects, without affecting sexual function, and with an improved quality of life for patients. We consider it essential to continue research on the Urolift<span class="elsevierStyleSup">®</span> treatment, paying special attention to patient selection criteria to meet those who could most benefit from the technique, and long-term results.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres517323" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Context" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Acquisition of evidence" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Summary of the evidence" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec538223" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres517322" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Contexto" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Adquisición de evidencia" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Síntesis de evidencia" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec538224" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Effectiveness results" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Safety results" ] ] ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-04-29" "fechaAceptado" => "2014-05-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec538223" "palabras" => array:5 [ 0 => "Prostate" 1 => "Urethral lift" 2 => "Benign prostatic hyperplasia" 3 => "Minimally invasive surgery" 4 => "Systematic review" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec538224" "palabras" => array:5 [ 0 => "Próstata" 1 => "Lift uretral" 2 => "Hiperplasia benigna prostática" 3 => "Cirugía mínimamente invasiva" 4 => "Revisión sistemática" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Context</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Interest in having alternatives in the treatment of benign prostate hyperplasia.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To assess the efficacy and safety of the Urolift<span class="elsevierStyleSup">®</span> system for treating the symptoms of benign prostate hyperplasia.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Acquisition of evidence</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Systematic review of the literature through searches on PubMed, Cochrane Library, CRD, Clinical Trials and EuroScan, collecting indicators of efficacy and safety.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Summary of the evidence</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We included 5 case series and one clinical trial. The patients’ mean age ranged from 65 to 74.3 years, and the mean prostate volume was 41–55<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span>. The mean number of Urolif<span class="elsevierStyleSup">®</span> implants was 3.7–5.5. The maximum follow-up in months was 24, 12 (3 studies) and one (2 studies). Improvements were found in lower urinary tract symptoms, as measured with the International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index (BPHII), maximum urinary flow (<span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>) and postvoid residual (PVR) volume. Improvements were found in sexual dysfunction symptoms, as measured with the Sexual Health Inventory for Men (SHIM) and the Male Sexual Health Questionnaire or Ejaculatory Dysfunction (MHSQ-EjD), and in quality of life (QoL). In the clinical trial, the differences were significant for International Prostate Symptom Score, BPHII, <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> and QoL (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05). The adverse effects were mild.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Although the quality of evidence is low, Urolift<span class="elsevierStyleSup">®</span> constitutes a good therapeutic alternative for patients with benign prostate hyperplasia. The short- to medium-term results show that the technique contributes to improving lower urinary tract symptoms, with no relevant side effects, and does not affect sexual function and improves quality of life. Further research is required, especially on long-term results.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Context" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Acquisition of evidence" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Summary of the evidence" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Contexto</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Interés por disponer de alternativas en el tratamiento de la hiperplasia benigna de próstata.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar la efectividad y seguridad del sistema Urolift<span class="elsevierStyleSup">®</span> para el tratamiento de los síntomas de la hiperplasia benigna de próstata.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Adquisición de evidencia</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Revisión sistemática de la literatura con búsqueda en PubMed, Cochrane Library, CRD, Clinical Trials y EuroScan, recogiéndose indicadores de efectividad y seguridad.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Síntesis de evidencia</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 5 series de casos y un ensayo clínico. La edad media de los pacientes osciló entre 65–74,3 años, y el volumen prostático medio entre 41-55<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">3</span>. El número medio de implantes Urolif<span class="elsevierStyleSup">®</span> fue de 3,7-5,5. El seguimiento máximo en meses fue de 24, 12 (3 estudios) y uno (2 estudios). Se encontraron mejoras en: síntomas del tracto urinario inferior medidos con International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index (BPHII), flujo urinario máximo (Qmax) y volumen residual postmiccional (PVR); síntomas de función sexual medidos con Sexual Health Inventory for Men (SHIM) y Male Sexual Health Questionnaire or Ejaculatory Dysfunction (MHSQ-EjD); y calidad de vida (QoL). En el ensayo clínico, las diferencias fueron significativas para International Prostate Symptom Score, BPHII, Qmax y QoL (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05). Los efectos adversos fueron leves.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Aunque la calidad de la evidencia es baja, Urolift<span class="elsevierStyleSup">®</span> constituye una buena alternativa terapéutica para pacientes con hiperplasia benigna de próstata. Los resultados a corto/medio plazo muestran que la técnica contribuye a mejorar los síntomas del tracto urinario inferior, sin efectos secundarios relevantes, sin afectar la función sexual y mejorando la calidad de vida. Sería preciso continuar la investigación especialmente sobre resultados a largo plazo.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Contexto" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Adquisición de evidencia" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Síntesis de evidencia" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Please cite this article as: Sánchez-Gómez LM, Polo-deSantos M, Gómez-Sancha F, Luengo-Matos S. Efectividad y seguridad del sistema Urolift<span class="elsevierStyleSup">®</span> para el tratamiento de los síntomas de la hiperplasia benigna de próstata: revisión sistemática. Actas Urol Esp. 2015;39:311–319.</p>" ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1616 "Ancho" => 1659 "Tamanyo" => 129385 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Flowchart of the publications included in the study.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reference \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reason for exclusion \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Without author \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Med Lett Drugs Ther 2013; 55(1429): 91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Comment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Arenas da Silva LF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Urologue A 2012; 51(12): 1697–702 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Article in German \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Barkin J \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Can J Urol 2012; 19(2): 6217–22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Review without data \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Berges R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Urologue A 2013; 52(3): 350–3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Article in German \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chung A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Curr Opin Urol 2014; 24(1): 36–41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Review without data \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps NB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Eur Urol 2012; 62(2): 350–1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Letter to the Editor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Kaplan SA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">J Urol 2012; 187(4): 1360 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Letter to the Editor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Kaplan SA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">J Urol 2013; 190(4): 1342 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Letter to the Editor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Larcher A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Curr Urol Rep 2013; 14(6): 620–7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Review without data \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lusardi L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Curr Opin Urol 2013; 23(1): 25–9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Review without data \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">NICE IPG 475 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Interventional Procedure Guideline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Guideline \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">NICE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Interventional Procedure overview \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Review \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Nickel JC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Rev Urol 2010; 12(2–3): e134–46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Abstract book \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Payton S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nat Rev Urol 2013; 10(12): 677 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Comment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Roumeguere T \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Prog Urol 2012; 22(15): 974–5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Letter to the Editor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tubaro A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Eur Urol 2011; 60(5): 1120–1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Letter to the Editor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Woo H \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">BJU International 2011; 108(1): 82–8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Duplicated study \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Woo H \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">J Sex Med 2012; 9(2): 568–75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Duplicated study \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835039.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Articles excluded and reason for exclusion.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">RCT: randomized clinical trial; CS: case series.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Level of evidence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Recommendation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ensayo LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835036.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Quality of evidence and grade of recommendation according to the scale of the Centre for Evidence Based Medicine at Oxford for treatment studies.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">SD: standard deviation; ND: no data; RCT: randomized clinical trial; CS: case series.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Design \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number of patients \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean age (SD) (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prostate volume Mean (SD) (cm<span class="elsevierStyleSup">3</span>) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of anesthesia (patients) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean surgical time (minutes) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean number of implants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean hospital stay (hours) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66.9 (7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Local (26)General (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55 (19.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">General (ND) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Spinal (2)Sedation (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.1<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20.6<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">102 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Local (18)Spinal (ND)General (ND) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57.8<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41.3 (11.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Local (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No stay \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">206Urolift<span class="elsevierStyleSup">®</span> patients: 140Control: 66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6765 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4541 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Local (169)Spinal (ND)General (ND) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66.2<span class="elsevierStyleHsp" style=""></span>m46.8<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835040.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">General data of included studies.</p>" ] ] 4 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">BPHII: percentage of improvement of the BPH impact index; RCT: randomized clinical trial; IPSS or AUASI: percentage of improvement of the International Prostate Symtom Score or the American Urological Association Symptom Index; PVR: percentage of improvement of the postvoid residual volume; <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>: percentage of improvement of the maximum urinary flow; ND: no data.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum follow-up time (months) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IPSS/AUASI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BPHII \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PVR \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (RCT: Urolift<span class="elsevierStyleSup">®</span> vs. control)12<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50% vs. 24%<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>49% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56% vs. 30%<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>59% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53% vs. 24.9%<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>59% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.3% vs. 26.5%<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>18% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835038.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">12-Month follow-up performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span>.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Lower urinary tract symptoms. Percentage of improvement after the surgery.</p>" ] ] 5 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">RCT: randomized clinical trial; MHSQ-EjD (1–3): percentage of improvement of questions 1–3 of the Male Sexual Health Questionnaire for Ejaculatory Dysfunction; MHSQ-EjD4: percentage of improvement of question 4 of the Male Sexual Health Questionnaire for Ejaculatory Disfunction; SHIM or IIEF5: percentage of improvement of the Sexual Health Inventory for Men or the International Index of Erectile Function.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum time of follow-up (months) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SHIM/IIEF5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MHSQ-EjD (1–3) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MHSQ-EjD4 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (RCT: Urolift<span class="elsevierStyleSup">®</span> vs. control)12<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.75% vs. 10.9%<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>2.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.3 vs. 19.3%<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>14% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33.3% vs. 31.8%<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>40% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835035.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0020"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">12-Month follow-up performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span>.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Sexual function symptoms. Percentage of improvement after the surgery.</p>" ] ] 6 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">RCT: randomized clinical trial; ND: no data.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum follow-up time (months) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">QoL \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (RCT: Urolift<span class="elsevierStyleSup">®</span> vs. control)12<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47.8% vs. 21.2%<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>51% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835041.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0030"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">12-Month follow-up performed only on patients in the group treated with Urolift<span class="elsevierStyleSup">®</span>.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Quality of life. Percentage of improvement after the surgery.</p>" ] ] 7 => array:7 [ "identificador" => "tbl0035" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">ND: no data.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Estudio Síntomas \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Chin<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Delongchamps<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Garrido<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">McNicolas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Shore<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LIFT<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">30,31</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dysuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes.Does not say N.° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.3% Urolift<span class="elsevierStyleSup">®</span> vs. 16.7% control \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hematuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes.Does not say N.° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.7% Urolift<span class="elsevierStyleSup">®</span> vs. 4.5% control \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urinary retention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7% Urolift<span class="elsevierStyleSup">®</span> vs. 1.5% control \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urgency symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.6% Urolift<span class="elsevierStyleSup">®</span> vs. 1.5% control \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urinary tract infections \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3% Urolift<span class="elsevierStyleSup">®</span> vs. 2% control \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Irritative symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes.Does not say N.° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Orchitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Erectile dysfunction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ejaculatory disorders \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Pelvic pain/discomfort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.9% Urolift<span class="elsevierStyleSup">®</span> vs. 4.5% control \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab835037.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Percentage of patients with adverse effects.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => 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