Presented by: David Bouhadana MD
Division of Urology, McGill University, Montreal, Quebec, Canada

Introduction

Under-representation of racial/ethnic minorities limits the external validity and generalizability of randomized controlled trials (RCT). This can worsen pre-existinghealth disparities. We sought to determine the extent of racial reporting and enrolment within RCTs of true minimally invasive surgical techniques (TMIST) for the office-based treatment of benight prostatic hyperplasia (BPH).

Materials

We conducted a systematic review of RCTs of office-based TMIST for the treatment of BPH. We searchedMEDLINE, Embase, and the Cochrane CENTRAL databases from inception through September 18th, 2022.Studies were excluded if they 1) did not discuss a minimally invasive surgical treatment for BPH; 2) were not randomized controlled trials (i.e. reviews, case reports, commentaries, or conference proceedings); or 3) were not published in the English language. Two reviewers independently screened the citations that were considered eligible for title, abstract and full-text screening, with conflicts resolved by a third reviewer. In addition to study characteristics, participant ethnicity and race enrolment and reporting were collected.

Results

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The included trials represented 2977 men. Sixteen studies reported on Transurethral microwave thermotherapy (TUMT), 6 on prostate arterial embolization (PAE), 2 on prostatic urethral lift (PUL), 1 on Temporarily Implanted Nitinol Device (iTIND), and 1 on water vapour therapy (WVT). Study publication years ranged between 2004 and 2021. Eight studies were conducted in the US and/or had authors with US affiliations. Characteristics of the studies are further detailed in Table 1. None of the retained studies reported on the race/ethnicity of the study participants.

Conclusion

There is a significant lack of racial/ethnic reporting in RCTs of TMIST for the treatment of BPH. Lack of racial reporting hinders the evaluation of racial enrolment. There is a need for the development of structured standards with regard to racial reporting and enrolment for RCTs of TMIST.

Funding

None.

Co-Authors

David-Dan Nguyen, MD,MPH
Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada

Anna-Lisa Nguyen, MD (c)
Schulich School of Medicine and Dentistry, London, Ontario, Canada

Rashid Sayyid, MD,MSc
Division of Urology, University of Toronto, Toronto, Ontario, Canada

Tuan Thanh Nguyen, MD
University of California Irvine

Kevin Zorn, MD
Division of Urology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada

Bilal Chughtai, MD
Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA

Dean Elterman, MD, MSc
Division of Urology, Dept. of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada

Quoc-Dien Trinh, MD,MBA
Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Christopher Wallis, MD, PHD
Division of Urology, University of Toronto, Toronto, Ontario, Canada

Naeem Bhojani, MD
Division of Urology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada