Photoselective Green-light Laser Vaporization Of The Prostate Versus Transurethral Resection Of The Prostate In Treating Benign Prostate Hyperplasia:a Meta-analysis

Objective: To assess the safety and efficacy of photoselective green-light laser vaporization of the prostate(PVP)and transurethral resection of the prostate(TURP)in the treatment of benign prostate hyperplasia(BPH).Methods: Randomised controlled trials comparing PVP and TURP were identified systematically using PubMed?OVID LWW?Web of Science?VIP?CNKI and other database search engines from their establishment to December 2015.After RCT screening data extraction and quality evaluation according to the criteria of inclusion and exclusion,adopt Revman 5.3 provided by Cochrane collaboration network for Meta analysis,including the index of safety(operation time,cather retention time,hospitalization time,complications,intraoperative blood loss)and efficacy(international prostate symptom score,quality of life assessment,maximum flow rate,postvoid residual volume).Results: 12 studies were included,involving 1463 patients,795 cases receiving PVP,668 cases receiving TURP.Meta analysis of these studies showed that there were statistically significant differences in the operative time[SMD=0.93,95%CI(0.53,1.33),P<0.00001],and operative time of TURP was shorter than PVP;The indwelling time of the catheterization also had statistically significant differences[SMD=-2.26,95%CI(-3.08,-1.43),P<0.00001],and PVP was shorter.There were also statistically significant differences in the hospitalization time[SMD=-2.25,95%CI(-3.12,-1.37),P<0.00001],and PVP had advantages.Transurethral resection syndrome,blood transfusion,prostatic capsule and bladder clot retention were statistically significant differences,and PVP was superior to TURP.There were also statistically significant differences in reoperation[RR=3.59,95%CI(1.53,8.46),P=0.003],and PVP occurred more.There was no statistically significant difference in the rest of the complications.Intraoperative blood loss also had statistically significant differences [ SMD=-0.69,95%CI[-1.06,-0.31],P=0.0003],PVP was less than TURP.Eventually,there was no statistically significant difference in IPSS?Qmax?PVR and QoL.Conclusions: For patients with BPH,PVP is better than TURP in terms of safety,but the operation time is longer.As regards efficacy,both of operation styles for the functional recovery of patients have similar effects.In summary,PVP is a safe and effective surgical method in the treatment of BPH,simultaneously more potential.