title: Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP) for relief of bladder outlet obstruction (BOO) on benign prostatic hyperplasia (BPH).
  
  
  METHODS
  A systematic literature search for randomized controlled trials (RCTs) comparing HoLEP and TURP in several databases from 1996 to 2011 were performed. Meta-analysis was conducted with the Review Manager Software.
  
  
  RESULTS
  Of 248 potential citations, 6 RCTs were included into our meta-analysis. There was no significant difference between the two groups in the maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS) at 1 month (p=0.41 and p=0.87) or 6 months (p=0.07 and p=0.37) after treatment. However, at 12 months postoperatively, the Qmax and IPSS in the HoLEP group were significantly better than those in the TURP group (p<0.0001 and p=0.01). The results also suggested a benefit of HoLEP over TURP in blood loss (p=0.001), catheterization time (p<0.0001), hospital stay (p=0.001), and blood transfusion rate (p=0.04), while the results favored TURP over HoLEP for operative time (p=0.001) and the incidence of postoperative dysuria (p=0.003).
  
  
  CONCLUSIONS
  Comparing with TURP, HoLEP showed slightly better postoperative results in Qmax and IPSS during 12-month follow-up, as well as significantly better perioperative results and similarly low complication rates. However, the operative time and the incidence of postoperative dysuria favor TURP. Generally, HoLEP is a promising minimal invasive alternative to TURP for treatment of BPH.
authors.affiliation: Department of Urology, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.forename: Jingfei
authors.initials: J
authors.lastname: Teng
authors.forename: Chien-Jung
authors.initials: CJ
authors.lastname: Huang
authors.forename: Xiangmin
authors.initials: X
authors.lastname: Zhang
authors.forename: Danfeng
authors.initials: D
authors.lastname: Xu
mesh_terms: D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000379:methods*; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery*