Holmium Laser Enucleation For Prostate Versus Transurethral Resection Of The Prostate In Treating Bening Prostate Hyperplasia: A Meta-analysis

Objective: To assess the efficacy and safety of holmium laserenucleation for prostate(HoLEP) and transurethral resections of the prostate(TURP) in the treatment of benign prostate hyperplasia (BPH).Methods:Randomised controlled trials (RCTs) comparing HoLEP andTURP were identified systematically using PubMed, Cochrane Library, theISI Web of Knowledge Databases and other database search engines fromtheir establishment to December2012. Results: a) safety: compared withthe TURP, HoLEP had less bleeding, bladder irrigation and postoperativecomplications, shorter catheterization time and hospital stay, but longeroperation time, there was no significant difference in quantity of resectedprostate and intraoperative complications. b) efficacy: there was nosignificant difference in the International Prostate Symptom Score (IPSS)except the12th month, HoLEP achieved lower score; there was nosignificant difference in the Quality Of Life (QoL) after1and3months. But in the6thand12th, HoLEP was higher; there was no significantdifference in maximum urinary flow rate (Qmax) after longer follow up;nor was the Postvoid Residua Urine Volume (PVR) after1and3months,but after6months、12months and24months, HoLEP achieved less.Conclusions: HoLEP had advantages over TURP in bleeding control,bladder irrigation, catheterization time, hospital stay and total postoperativecomplications except for operation time. There were no significantdifferences in the quantity of resected prostate, intraoperativecomplications and short term follow up. However, HoLEP seems tooutperform TURP through long term observation. Increasing the number ofquality prospective RCTs with adequate follow-up is mandatory totailoreach technique to the right patient.