Efficacy And Safety Assessment Of TUEVP, PKVP And TURP For The Treatment Of Benign Prostatic Hyperplasia: Meta-analysis

Objective: To compare and evaluate effectiveness and safety of transurethral electrovaporization of the prostate(TUEVP), and transurethral plasmakinetic electrovaporization resection of prostate(PKVP), with transurethral resection of the prostate(TURP).Methods: The randomized controlled trials (RCT), non-randomized controlled trials (NRCT) of both Chinese and English studies about TUEVP vs TURP and PKVP vs TURP for the treatment of BPH all over the world were searched by Pubmed, Ovid, ScineceDirect, NGC, EBSCO, EMBASE, CNKI, CBM, as well as manual search of four Chinese journals: Chinese of Journal of Androloy, National Journal of Androlgy, Chinese Journal of Urology, Journal of Clinical Urology. Two reviewers independently screened the studies for eligibility,evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Different opinion were settled by discussion or consulted by the expert. Meta-analysis was processed by Rev Man 5.0, fail-safe number (Nfs) was performed by SAS8.0.Results: 30 RCTs or NRCTs were enrolled the inclusion criteria in Meta analysis. The baseline of patients'characteristics was comparable in all the studies. By evaluating the relevant indicators, side effects and complications between TUEVP or PKVP and TURP, the statistically significant differences of pooled estimates suggested a benefit of TUEVP over TURP for bladder wash-out time, catheterization time, hospital stay, incidence of ED. In contrast, incidence of postoperative secondary hemorrhage is 2.17 times higher than TURP. MFR improved better in TURP than in TUEVP. The mean operation time, intraoperative hemorrhage,catheterization time and hospital stay in PKVP were shorter than TURP. Incidence of urethral stricture, postoperative secondary hemorrhage, TURS is lower(50%, 78% and 72%, respectively)in PKVP than in TURP.Conclusion: Our results showed that the three therapies of the prostate were all safe and effective for transurethral resection of BPH with less intraoperative and postoperative complications, especially TUEVP and PKVP.