Probabilistic Multicriteria Decision Analysis of Minimally Invasive Treatments for Benign Prostatic…

Meta-analysisLower urinary tract symptoms· Jul 2026

Probabilistic Multicriteria Decision Analysis of Minimally Invasive Treatments for Benign Prostatic Obstruction: A Secondary Analysis of Network Meta-Analysis Data.

Shugo Yajima, Soichiro Yoshida, Wei Chen … Yasuhisa Fujii

Benign Prostatic DiseaseMeta-analysisTreatment

Monopolar transurethral resection of the prostate is preferred for urodynamic outcomes.

Probabilistic Multicriteria Decision Analysis of Minimally Invasive Treatments for Benign Prostatic Obstruction: A Secondary Analysis of Network Meta-Analysis Data.

Shugo Yajima … Yasuhisa Fujii

Lower urinary tract symptoms · Jul 2026

Purpose

To compare minimally invasive surgical therapies (minimally invasive surgical therapies) for benign prostatic obstruction (benign prostatic obstruction) using probabilistic multicriteria decision analysis that integrates heterogeneous clinical outcomes under varying stakeholder priorities.

Methods

This secondary analysis was derived from a published network meta-analysis.

Results

Monopolar transurethral resection of the prostate had an 88.0% probability of being best for efficacy.

net advantage 0.12 (95% CI 0.03 to 0.21)

null 0

0.03

0.21

CI excludes the null - significant

More results

Under equal weights, water vapor thermal therapy had the highest P(best) (54.1%), followed by mTURP (25.8%) and prostatic urethral lift (20.1%); all pairwise UIs crossed zero.

Under sexual function weights, mTURP was rarely preferred (P[best] < 0.1%), whereas prostatic urethral lift and water vapor thermal therapy achieved P(best) of 45.3% and 54.7%, respectively.

More results

Rankings were robust in both anchor perturbation and correlation sensitivity analyses.

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Conclusion · 1 of 3

Within short-term (3-6 month) data, minimally invasive surgical therapies preference for benign prostatic obstruction depends on clinical priorities.

Conclusion · 2 of 3

mTURP is favored when urodynamic outcomes are emphasized; prostatic urethral lift and water vapor thermal therapy are preferred when preservation of sexual function is prioritized.

Conclusion · 3 of 3

This framework supports preference-sensitive shared decision-making, although the findings are provisional pending long-term data.

Probabilistic Multicriteria Decision Analysis of Minimally Invasive Treatments for Benign Prostatic Obstruction: A Secondary Analysis of Network Meta-Analysis Data.

Probabilistic Multicriteria Decision Analysis of Minimally Invasive Treatments for Benign Prostatic Obstruction: A Secondary Analysis of Network Meta-Analysis Data.

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