title: 'Button type' bipolar plasma vaporisation of the prostate compared with standard transurethral resection: a systematic review and meta-analysis of short-term outcome studies.
abstract: OBJECTIVE
  To evaluate the surgical morbidity and effectiveness in improving symptoms of benign prostatic hyperplasia (BPH), comparing 'button-type' bipolar plasma vaporisation (BTPV) vs transurethral resection of the prostate (TURP).
  
  
  METHODS
  We conducted a literature search of published articles until November 2014. Only prospective and randomised studies with comparative data between BTPV and conventional TURP (mono- or bipolar) were included in this review.
  
  
  RESULTS
  Six articles were selected for the analyses. In the 871 patients evaluated, 522 underwent TURP and 349 BTPV. There was a tendency for a higher transfusion rate in the TURP group, with two BTPV cases (0.006%) and 16 TURP cases (0.032%) requiring transfusions (P = 0.06). The number of complications was similar between the groups (odds ratio 0.33, 95% confidence interval [CI] 0.8-1.31; P = 0.12; I(2) = 86%). When subdivided by severity, 10.7% (14/131) and 14.6% (52/355) of complications were classified as severe (Clavien 3 or 4) in patients who underwent BTPV and TURP, respectively (P = 0.02). The average duration of indwelling catheterisation was significantly less in patients who underwent BTPV (standardised mean difference [SMD] -0.84; 95% CI -1.54 to 0.14; P = 0.02; I(2) = 81%). Both treatments significantly improved symptoms and the postoperative International Prostate Symptom Score was similar in both groups (SMD 0.09, 95% CI -1.56 to 1.73; P = 0.92).
  
  
  CONCLUSIONS
  BTPV is an effective and safe treatment for BPH. The improvement of urinary symptoms and overall complications are comparable to conventional TURP. However, BTVP appears to be associated with a lower rate of major complications and duration of indwelling catheterisation.
authors: Hospital Israelita Albert Einstein, São Paulo, Brazil.|ABC Medical School, São Paulo, Brazil.
authors: Marcelo L
authors: ML
authors: Wroclawski
authors: Hospital Israelita Albert Einstein, São Paulo, Brazil.|ABC Medical School, São Paulo, Brazil.
authors: Arie
authors: A
authors: Carneiro
authors: ABC Medical School, São Paulo, Brazil.
authors: Rodrigo Dal Moro
authors: RD
authors: Amarante
authors: ABC Medical School, São Paulo, Brazil.
authors: Carlos E B
authors: CE
authors: Oliveira
authors: ABC Medical School, São Paulo, Brazil.
authors: Victor
authors: V
authors: Shimanoe
authors: ABC Medical School, São Paulo, Brazil.
authors: Bianca A V
authors: BA
authors: Bianco
authors: ABC Medical School, São Paulo, Brazil.
authors: Paulo K
authors: PK
authors: Sakuramoto
authors: ABC Medical School, São Paulo, Brazil.
authors: Antonio C L
authors: AC
authors: Pompeo
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000706:statistics & numerical data; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: benign prostatic hyperplasia (BPH); prostate transurethral vaporesection; transurethral resection of prostate (TURP)