Search

Abstract. Objective. The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH) treated with prostatic Aquablation. Materials and methods. We performed a literature search of clinical trials using the MEDLINE, Embase, and Cochrane Library databases and retrieved published works on Aquablation for the treatment of BPH up to August 2021. Unpublished works, case reports, conference proceedings, editorial comments, and letters were excluded. Risk of bias was assessed using the ROBINS-I tool. Raw means and mean differences were meta-analyzed to produce summary estimates for pre- versus post-International Prostate Symptom Scores, maximum flow rate, and male sexual health questionnaire value changes. An inverse-variance weighted random effects model was used. Results. Seven studies were included in this review (n = 551 patients) that evaluated various urological parameters. At 3 months, the International Prostate Symptom Scores raw mean difference from baseline was −16.475 (95% confidence interval [CI], −15.264 to −17.686; p < 0.001), with improvements sustained for 12 months. Similarly, maximum flow rate improved by +1.96 (95% CI, 10.015 to 11.878; p < 0.001) from pre to 3 months postoperatively. In addition, the male sexual health questionnaire change pooled effect size was −0.55 (95% CI, −1.621 to 0.531; p = 0.321) from preintervention to postintervention at 3 months. Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias. Conclusions. Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function. Further research is required to confirm these preliminary results.

Elaborate plumages and songs in male birds provide classic evidence for Darwinian sexual selection. However, trait elaboration in birds is not gender-restricted: female song has recently been revealed as a taxonomically-widespread trait within the songbirds (oscine Passerines), prompting increased research into likely functions and social/ecological correlates. Here we use phylogenetically-informed comparative analysis to test for an evolutionary association between female song and plumage color elaboration in songbirds. If there is an evolutionary trade-off between signaling modes, we predict a negative correlation between acoustic and visual elaboration. This trade-off hypothesis has been commonly proposed in males but has mixed empirical support. Alternatively, if song and plumage have similar or overlapping functions and evolve under similar selection pressures, we predict a positive correlation between female song and female plumage elaboration. We use published data on female song for 1,023 species of songbirds and a novel approach that allows for the reliable and objective comparison of color elaboration between species and genders. Our results reveal a significant positive correlation between female colorfulness and female song presence. In species where females sing, females (but not males) are on average more colorful – with concomitantly reduced average sexual dichromatism. These results suggest that female plumage and female song likely evolved together under similar selection pressures and that their respective functions are reinforcing. We discuss the potential roles of sexual versus social selection in driving this relationship, and the implications for future research on female signals.