A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization
Abstract. Background. We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP). Methods. Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched fo...
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Wolters Kluwer Health
2025-01-01
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| Series: | Current Urology |
| Online Access: | http://journals.lww.com/10.1097/CU9.0000000000000247 |
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| author | Zhichao Wang Zicheng Tan Mengzhen Qiu Longyang Zhang |
| author_facet | Zhichao Wang Zicheng Tan Mengzhen Qiu Longyang Zhang |
| author_sort | Zhichao Wang |
| collection | DOAJ |
| description | Abstract. Background. We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP).
Methods. Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels.
Results. Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I2, 92%), 3 months (MD, 2.78, 95% CI, 0.53–5.02, p = 0.02, I2, 89%), 6 months (MD, 2.13, 95% CI, 1.11–3.15, p < 0.0001, I2, 87%), and 12 months (MD, 3.98, 95% CI, 2.06–5.89, p < 0.0001, I2, 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005).
Conclusions. Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials. |
| format | Article |
| id | doaj-art-18288de2e8cc4ce2948533828fcd6a20 |
| institution | DOAJ |
| issn | 1661-7649 1661-7657 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Current Urology |
| spelling | doaj-art-18288de2e8cc4ce2948533828fcd6a202025-08-20T03:09:11ZengWolters Kluwer HealthCurrent Urology1661-76491661-76572025-01-01191172910.1097/CU9.0000000000000247202501000-00003A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporizationZhichao Wang0Zicheng Tan1Mengzhen Qiu2Longyang Zhang3a Department of Urology, Jinan Central Hospital, Shandong University, Jinan, Chinab Department of Urology, Jinan Central Hospital, Shandong Second Medical University, Jinan, Chinac Department of Urology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Chinaa Department of Urology, Jinan Central Hospital, Shandong University, Jinan, ChinaAbstract. Background. We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP). Methods. Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels. Results. Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I2, 92%), 3 months (MD, 2.78, 95% CI, 0.53–5.02, p = 0.02, I2, 89%), 6 months (MD, 2.13, 95% CI, 1.11–3.15, p < 0.0001, I2, 87%), and 12 months (MD, 3.98, 95% CI, 2.06–5.89, p < 0.0001, I2, 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005). Conclusions. Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.http://journals.lww.com/10.1097/CU9.0000000000000247 |
| spellingShingle | Zhichao Wang Zicheng Tan Mengzhen Qiu Longyang Zhang A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization Current Urology |
| title | A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| title_full | A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| title_fullStr | A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| title_full_unstemmed | A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| title_short | A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| title_sort | meta analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization |
| url | http://journals.lww.com/10.1097/CU9.0000000000000247 |
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