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Meta-analysisLower urinary tract symptoms · 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

UrologyMeta-analysis

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 et al. · Lower urinary tract symptoms · 2026

Purpose

To compare minimally invasive surgical therapies (MISTs) for benign prostatic obstruction (BPO) 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, WVTT had the highest P(best) (54.1%), followed by mTURP (25.8%) and PUL (20.1%); all pairwise UIs crossed zero.

Under sexual function weights, mTURP was rarely preferred (P[best] < 0.1%), whereas PUL and WVTT achieved P(best) of 45.3% and 54.7%, respectively.

More results

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

“

Conclusion · 1 of 2

Within short-term (3-6 month) data, MIST preference for BPO depends on clinical priorities. mTURP is favored when urodynamic outcomes are emphasized; PUL and WVTT are preferred when preservation of sexual function is prioritized.

Conclusion · 2 of 2

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

Post

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

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

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