Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis o
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ORIGINAL ARTICLE
Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials Wei Haibin 1,2 & Qian Lin 1 & Wu Junxiu 1 & Wang Heng 3 & Zhang Qi 2 & Wang Yanpeng 4 & Zhang Dahong 1,2 Received: 16 May 2020 / Accepted: 25 September 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract The benefit of transurethral laser prostatectomy over open simple prostatectomy (OSP) is controversial in aged symptomatic benign prostatic hyperplasia (BPH) patients with large volume prostates, and the aim of this study is to compare the safety and efficiency of these two methods. Meta-analysis was applied using the Review Manager V5.3 software and the retrieved randomized controlled clinical trials (RCTs) comparing transurethral laser prostatectomy with OSP were analyzed for the treatment of large volume prostates from 2000 to 2019 in PubMed, Web of Science, Cochrane, and EMBASE datasets. Five RCTs assessing transurethral laser prostatectomy versus OSP were considered suitable for this meta-analysis, which included a total of 448 patients, with 232 patients undergoing laser and 216 patients undergoing OSP. Compared with OSP, although transurethral laser prostatectomy required a longer operative time (weighted mean difference (WMD) 27.49 mins; 95% confidence interval (CI) 16.54–38.44; P < 0.00001) and obtained a less resected prostate weight (WMD − 11.72 g; 95% CI − 21.75 to − 1.70; P = 0.02), patients undergoing laser prostatectomy benefited from significantly less hemoglobin decline (− 0.97 g/dL; 95% CI − 1.31 to − 0.64; P < 0.00001), shorter time of catheterization (WMD − 3.67 days; 95% CI − 5.60 to − 1.75; P = 0.0002), shorter length of hospital stay (WMD − 4.75 days; 95% CI − 6.57 to − 2.93; P < 0.00001), and less blood transfusion (odds ratio 0.10; 95% CI 0.03 to 0.35; P = 0.0003). During postoperative follow-up, no significant difference was observed between the two groups in IPSS, QoL, Qmax, and PVR. Both transurethral laser prostatectomy and OSP are safe and effective for large prostates that require prostate resection. Taking into account of less blood loss, shorter catheterization time and hospital stay, and less blood transfusion, transurethral laser prostatectomy may be a better treatment for patients with large prostates. Keywords Benign prostatic hyperplasia . Laser surgery . Laser . Transurethral resection of the prostate . Open prostatectomy
Introduction Wei Haibin and Qian Lin contributed equally to this work. * Wang Yanpeng [email protected] * Zhang Dahong [email protected] 1
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
2
Department of Urology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Xiacheng District, Hangzhou 310014, Zhejiang, China
3
Bengbu Medical College, Bengbu 233030, Anhui, China
4
Department of Gynecology, Zhejiang Provincial People’s Hospital, No.
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