title: [A meta-analysis of holmium laser enucleation of the prostate for benign prostatic hyperplasia].
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP)/open prostatectomy (OP) in the treatment of bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH).
  
  
  METHODS
  We searched Medline, Cochrane Library, Embase, Wanfang and CBM for randomized controlled trials (RCT) comparing HoLEP with TURP/OP. Comparable data were extracted from eligible studies and pooled for meta-analysis using RevMan5.1.
  
  
  RESULTS
  Nine RCTs were included in this study, 6 comparing HoLEP with TURP, and the other 3 comparing HoLEP with OP. Meta-analysis showed that, compared with TURP, HoLEP was associated with shorter hospital stay and catheterization time, less hemoglobin loss, longer operative time, and better improvement in international prostate symptom score (IPSS) , peak urinary flow rate (Qmax) and post void residual (PVR) , but the incidences of postoperative urethral stricture and urinary incontinence had no statistically significant difference between the two. Compared with OP, HoLEP showed shorter hospital stay and catheterization time, a lower rate of blood transfusion, longer operative time, and removal of fewer tissues, but the two procedures exhibited no significant differences in either the improvement of IPSS and Qmax or the incidence of urethral stricture.
  
  
  CONCLUSIONS
  HoLEP is a minimally invasive technique, safe and highly effective for the treatment of BOO secondary to BPH, with its advantages of lower peri-operative morbidity and faster recovery over TURP and OP. However, more high-quality RCTs with larger sample sizes and longer follow-ups need to be carried out to obtain better evidence.
authors.affiliation: Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.
authors.forename: Chu-Biao
authors.initials: CB
authors.lastname: Zhao
authors.forename: Ju-Cong
authors.initials: JC
authors.lastname: Li
authors.forename: Ping-Qing
authors.initials: PQ
authors.lastname: Yuan
authors.forename: Ying-Qia
authors.initials: YQ
authors.lastname: Hong
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.forename: Shan-Chao
authors.initials: SC
authors.lastname: Zhao
mesh_terms: D006695:Holmium; D006801:Humans; D053685:Laser Therapy; D008297:Male; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D006695:Holmium