Meta-analysis of holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction.
BACKGROUND
Holmium laser enucleation (HoLEP) is an alternative to transurethral resection (TURP) of the prostate for symptomatic prostatic obstruction.


METHODS
Randomized controlled trials comparing HoLEP and TURP were identified systematically using Medline, Embase and The Cochrane Library. Primary outcomes were peak urinary flow rate (Qmax), postvoid residual volume, symptom score and quality of life. Secondary outcomes were duration of operation, hospital stay, blood loss, catheterization time and adverse events.


RESULTS
There was no statistically significant difference between HoLEP and TURP in terms of Qmax at 6 and 12 months' follow-up. HoLEP was associated with significantly less blood loss, a shorter catheterization time and a shorter hospital stay. TURP was associated with reduced operating time. The techniques were similar in terms of urethral stricture, stress incontinence, transfusion requirement and rate of reintervention.


CONCLUSIONS
HoLEP and TURP provide a similar improvement in Qmax. HoLEP, however, has several advantages over TURP, despite requiring more operating time. It is at least as safe as TURP in terms of adverse events.
Tan
A
A
Department of Urology, First Affiliated Hospital, Guangxi Medical University, Guangxi, China.
Liao
C
C
Mo
Z
Z
Cao
Y
Y
D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D053844:Lasers, Solid-State; D008297:Male; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000295:instrumentation*; D016055:Urinary Retention / Q000503:physiopathology / Q000601:surgery*; D014554:Urination / Q000502:physiology