title: Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis.
abstract: All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Xingming
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Shen
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Qiying
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Xiaoxue
authors.initials: X
authors.lastname: Yin
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Haojun
authors.initials: H
authors.lastname: Gui
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Kunpeng
authors.initials: K
authors.lastname: Shu
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Qidun
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Yaojing
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Xiuyi
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Ni
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome