All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis.
To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.
Scientific reports. 2016 Mar 24*** epublish ***
Xingming Zhang, Pengfei Shen, Qiying He, Xiaoxue Yin, Zhibin Chen, Haojun Gui, Kunpeng Shu, Qidun Tang, Yaojing Yang, Xiuyi Pan, Jia Wang, Ni Chen, Hao Zeng
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.