Purpose:To determine whether photoselective vaporization has advantages over transurethral resection of the prostate (TURP) in terms of effectiveness and safety for treatment of patients with benign prostatic hyperplasia.
Materials and Methods:MEDLINE, EMBASE, and the Cochrane Controlled Trial Register were searched for randomized controlled trials. The risk ratio, mean difference, and their corresponding 95% confidence intervals were calculated for dichotomous and continuous outcomes, respectively. Risk of bias of enrolled trials was assessed according to Cochrane Handbook.
Results:A total of five trials were enrolled. There was no significant difference in the International Prostate Symptom Score and maximum flow rate between photoselective vaporization and TURP at 6-, 12-, and 24-month follow-up. Photoselective vaporization was associated with significantly lower risk of capsule perforation, transurethral resection syndrome, and clot retention, significantly lower transfusion requirements, a shorter catheterization time, and a shorter length of hospital stay. TURP was associated with a shorter operative time and a lower risk of reoperation. In addition, there was no difference in risk of acute urinary retention and urethral/bladder neck sclerosis between photoselective vaporization and TURP.
Conclusions: Photoselective vaporization and TURP provide comparable improvements in functional results, including International Prostate Symptom Score and maximum flow rate at 6-, 12-, and 24-month follow-up. Photoselective vaporization offers advantages over TURP in terms of intraoperative safety; however, TURP is found to have a shorter operative time and lower reoperative risk.
Written by:
Zhang X, Geng J, Zheng J, Peng B, Che J, Liang C. Are you the author?
Department of First Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
Reference: J Endourol. 2012 Sep;26(9):1109-17.
doi: 10.1089/end.2012.0136
PubMed Abstract
PMID: 22494418
