title: Greenlight high-performance system (HPS) 120-W laser vaporization versus transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: a meta-analysis of the published results of randomized controlled trials.
abstract: To assess the efficacy and the safety of Greenlight(TM) high-performance system (HPS) 120-W laser photoselective vaporization of the prostate (PVP) compared with transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH). The related original studies only including randomized controlled trials were searched by databases MEDLINE, EMBASE, Google Scholar, and the Cochrane Controlled Trial Register. The databases were updated till July 2014. The risk ratio, mean difference, and their corresponding 95% confidence intervals were calculated. Risk of bias of the enrolled trials were assessed according to Cochrane Handbook. A total of four trials involving 559 patients were enrolled. Statistical analysis was performed by software Review Manager (V5.3.3). There was no significant difference in International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) between PVP and TURP at 6-, 12-, and 24-month follow-up. Patients in the PVP group were associated with significantly lower risk of capsule perforation (risk ratio (RR) = 0.06, 95% confidence interval (95%CI) = 0.01 to 0.46; p = 0.007), significantly lower transfusion requirements (RR = 0.12, 95%CI = 0.03 to 0.43; p = 0.001), a shorter catheterization time (mean difference (MD) = -41.93, 95%CI = -54.87 to -28.99; p < 0.00001), and a shorter duration of hospital stay (MD = -2.09, 95%CI = -2.58 to -1.59; p < 0.00001) than that in the TURP group. In the TURP group, the patients were associated with a lower risk of re-operation (RR = 3.68, 95%CI = 1.04 to 13.00; p = 0.04) and a shorter operative time (MD = 9.28, 95%CI = 2.80 to 15.75; p = 0.005) than those in the PVP group. In addition, no statistically significant differences were detected between groups in terms of the rates of transurethral resection syndrome, urethral stricture, bladder neck contracture, incontinence, and infection. Greenlight(TM) 120-W laser PVP is as effective as TURP for symptom reduction and improvement of the quality of life. Laser PVP shows advantages over TURP in terms of intraoperative safety, whereas TURP is found to have a shorter operative time and lower re-operative risk.
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Yan
authors: Y
authors: Zhou
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China. xbxcp@hotmail.com.
authors: Boxin
authors: B
authors: Xue
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Nadeem Ahmed
authors: NA
authors: Mohammad
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Dong
authors: D
authors: Chen
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Xiaofei
authors: X
authors: Sun
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Jinhui
authors: J
authors: Yang
authors: Department of Urology, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Suzhou, Jiangsu, China.
authors: Guangcheng
authors: G
authors: Dai
mesh_terms: D006801:Humans; D053685:Laser Therapy; D008297:Male; D011467:Prostate / Q000601:surgery*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome; D014835:Volatilization
keywords: Benign prostatic hyperplasia; GreenlightTM 120-W HPS; Meta-analysis; Photoselective vaporization; Transurethral resection of the prostate