Objective:

To evaluate the clinical outcomes of simultaneous outlet surgery and stone removal versus isolated stone removal in men with bladder stones and benign prostatic obstruction (BPO), specifically focusing on the comparative effectiveness of these approaches.

Key Findings:

• High stone clearance rates were observed regardless of surgical strategy, but variability in stone recurrence, functional outcomes, and complication profiles suggests a need for careful patient selection.
• Marked variability in stone recurrence, functional outcomes, and complication profiles.
• The necessity of concomitant outlet surgery remains debated, indicating a need for further investigation.

Interpretation:

The findings suggest that while stone removal is effective, the routine performance of simultaneous outlet surgery may not be justified based on current evidence, highlighting the importance of individualized patient assessment.

Limitations:

• Studies included were heterogeneous in design and quality, which may affect the generalizability of the results.
• Most evidence derived from non-randomized studies with potential biases that could skew outcomes.
• Limited standardization in evaluating patient-centered outcomes, which may impact treatment decisions.

Conclusion:

Further research is needed to clarify the role of concomitant outlet surgery in the management of bladder stones and BPO, emphasizing individualized patient assessment and suggesting specific areas for future research.