Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

Wei, Haibin; Lin, Qian; Junxiu, Wu; Wang, Heng; Zhang, Qi; Wang, Yanpeng; Zhang, Dahong

doi:10.1007/s10103-020-03153-5

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…Transurethral laser surgery was considered to have various advantages over OP in terms of blood loss, hospital stay, and catheterization days, while there was no significant difference was observed in resected prostate weight (p=0.62) and operative time (p=0.43). In the previous meta-analysis, OP was proved to have the advantage of a shorter operative time and more resected weight compared with laser surgery, which was inconsistent with the current result [ 33 ]. All studies included in the previous meta-analysis were before 2008, and the current meta-analysis includes 2016 to 2019.…”

Section: Discussionmentioning

confidence: 65%

“…According to our previous results, there were 2 low-quality RCTs and 3 high-quality RCTs according to the Jadad scale [ 33 ]. Sensitivity analysis was performed using 3 high-quality RCTs, and the corresponding results were shown in Table 5 .…”

Section: Resultsmentioning

confidence: 99%

“…How to choose a more suitable surgical method for BPH with large prostates is difficult but be of great importance, and it is worthy of comparing transurethral laser prostatectomy and OP for large-sized prostates. In our previous meta-analysis, transurethral laser prostatectomy was proven to be an appropriate treatment for large prostates with the advantages of less intraoperative blood loss, and shorter postoperative catheterization time and hospital stay [ 33 ]. However, there were two limitations in the previous study.…”

Section: Discussionmentioning

confidence: 99%

“…The published meta-analysis needs to be updated, and transurethral bipolar enucleation needs to be eliminated to avoid potential bias [ 12 ]. Built on previous work of us and Lin, new meta-analysis included recent studies with larger sample sizes is very necessary to resolve this clinical dispute of large prostates [ 12 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trials

Wei

Guo

et al. 2022

Investig Clin Urol

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Purpose The selection of open prostatectomy (OP) over transurethral laser surgery is controversial for large volume prostates. Thus, we aim to compare the efficacy and safety of transurethral laser versus OP, and provide the latest evidence of clinical practice for large-sized benign prostatic hyperplasia (BPH). Materials and Methods This meta-analysis used Review Manager V5.3 software and the systematic literature search of Cochrane Library, Embase, PubMed, and Web of Science datasets was performed for citations published from 2000 to 2020 that compared transurethral laser with OP for the treatment of large BPH. Variables of interest assessing the two techniques included clinical characteristics, and the perioperation-, effectiveness-, and complication-related outcomes. Results The meta-analysis included twelve studies containing 1,514 patients, with 792 laser and 722 OP. The transurethral laser group was associated with shorter hospital stay and catheterization duration, and less hemoglobin decreased in the perioperative variables. There was no significant difference in the international prostate symptom score, post-void residual urine volume, maximum flow rate, and quality of life score. Transurethral laser group had a significantly lower incidence of blood transfusion than OP group (odds ratio, 0.10; 95% confidence interval, 0.05 to 0.19; p<0.001; I 2 =8%), and no statistical differences were found with respect to the other complications. Conclusions Both OP and transurethral laser prostatectomy are effective and safe treatments for large prostate adenomas. With these advantages of less blood loss and transfusion, and shorter catheterization time and hospital stay, laser may be a better choice for large BPH.

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Section: Discussionmentioning

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trials

Wei

Guo

et al. 2022

Investig Clin Urol

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“…OSP, though is an effective method in patients with large prostates, is currently the most invasive surgery in patients with BPH. In a meta-analysis comparing OSP with transurethral laser prostatectomy, OSP was associated an increased hemoglobin decline, longer catheterization time, longer hospital stay and increased blood transfusion rate [ 14 ]. Thus, owing to these limitations, other treatments for large prostates should be explored.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of the Sandwich Method in Patients with Benign Prostate Hyperplasia: Bipolar Transurethral Resection with GreenLight Vaporization

Lin

Chang

Shao

et al. 2022

JCM

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Benign prostate hyperplasia (BPH) refers to the nonmalignant enlargement of the transition zone of the prostate gland. While holmium laser enucleation of the prostate and open simple prostatectomy are effective in the management of patients with large prostates, they have some limitations. Thus, this study aimed to analyze the efficacy and safety of the sandwich method of bipolar transurethral resection of the prostate (B-TURP) and GreenLight photoselective vaporization of the prostate (GLPVP) in patients with large prostates. Patients diagnosed with BPH who underwent the sandwich method with B-TURP and GLPVP from 2015 to 2020 were included. Efficacy analyses included the change in the uroflowmetry results in both group A (prostate volume < 80 g) and group B (prostate volume ≥ 80 g), and complication analyses included perioperative complications, early postoperative complications at three months and late postoperative complications at 12 months. The cohort comprised 188 and 44 patients in groups A and B, respectively. The prostate volume of groups A and B were 50.83 ± 14.14 g and 102.03 ± 19.36 g (p < 0.001), respectively. The peak (Qmax) and average (Qavg) flow rates were comparable between the two groups. The only significant difference noted was in the postoperative post-void residual (PVR) urine. Improvement was seen in all the variables including the Qmax, Qavg and PVR urine in each group. No patient experienced perioperative complications. Analysis of the overall one-year complication rate showed no significant difference between the two groups. The sandwich method of B-TURP and GLPVP may be feasible for the management of patients with large prostate.

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Urology

Griebling

2021

Geriatrics for Specialists

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Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

Cited by 12 publications

References 31 publications

Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trials

Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trials

Efficacy and Safety of the Sandwich Method in Patients with Benign Prostate Hyperplasia: Bipolar Transurethral Resection with GreenLight Vaporization

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