title: Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of transurethral enucleation of the prostate (TUEP) versus transvesical open prostatectomy (OP) for the management of large benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Randomized controlled trials (RCTs) comparing TUEP and OP were identified from PubMed, Embase and Web of Science up to February 28, 2015. A meta-analysis was conducted with the STATA 12.0 software.
  
  
  RESULTS
  Nine RCTs including 758 patients were enrolled in our meta-analysis. There were no significant differences between the two groups in the maximum urinary flow rate at 1, 3, 6 months, 1 and 2 years: postvoiding residual urinary volume, prostate-specific antigen, international prostate symptom score and quality of life score at 1, 3, 6 months and 1 year; or international index of erectile function at 3, 6 months and 1 year. Perioperative outcomes including hemoglobin level drop, catheter period, irrigation length and hospital stay favored TUEP, while operative time and resected prostate weight favored OP. There was significantly less blood transfusion with TUEP, but no significant differences were found in other complications such as recatheterization, urinary tract infection, reintervention for clots and bleeding control, incidence of pneumonia and infarction, transient incontinence, bladder neck contracture, urethral stricture and recurrent adenoma.
  
  
  CONCLUSIONS
  TUEP can be performed effectively and safely with functional outcomes and complications similar to OP for large BPH, whereas it has the advantages of a shorter catheter period, shorter hospital stays and less blood transfusion. These findings seem to support TUEP as the next-generation "gold standard" of surgery for large BPH.
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.|Department of Urology, Fujian Provincial Clinical College, Fujian Medical University, Fuzhou, China.
authors.forename: Youcheng
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Urology, The First Affiliated Hospital of Jinan University, No. 613, HuangPu Road (West), TianHe District, Guangzhou, 510630, China.|Department of Anatomy, School of Basic Medicine Science, Southern Medical University, Guangzhou, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
authors.forename: Abai
authors.initials: A
authors.lastname: Xu
authors.affiliation: Department of Urology and Andrology, Zhongshan City People's Hospital of Sun Yat-sen University, Zhongshan, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ren
authors.affiliation: Department of Occupational Health and Occupational Medicine, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.
authors.forename: Xueqiong
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wen
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Department of Urology and Andrology, Zhongshan City People's Hospital of Sun Yat-sen University, Zhongshan, China.
authors.forename: Mancheng
authors.initials: M
authors.lastname: Gong
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China. liuchx888@163.com.
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Urology, The First Affiliated Hospital of Jinan University, No. 613, HuangPu Road (West), TianHe District, Guangzhou, 510630, China. suz2008@126.com.|Department of Anatomy, School of Basic Medicine Science, Southern Medical University, Guangzhou, China. suz2008@126.com.
authors.forename: Zexuan
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Urology and Urological Oncology, Hanover Medical School (MHH), Carl Neuberg Str. 1, 30625, Hanover, Germany. Herrmann.Thomas@mh-hannover.de.
authors.forename: Thomas R W
authors.identifier: http://orcid.org/0000-0003-4493-1301
authors.initials: TR
authors.lastname: Herrmann
mesh_terms: D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D014521:Urethra; D001743:Urinary Bladder
keywords: Bipolar enucleation; ICBEP; International Consultation in Bipolar Enucleation of the Prostate; Large benign prostatic hyperplasia; Meta-analysis; Open prostatectomy; PKEP; Transurethral enucleation