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Lasers in Medical Science

Erschienen in:

12.10.2020 | Original Article

Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

verfasst von: Wei Haibin, Qian Lin, Wu Junxiu, Wang Heng, Zhang Qi, Wang Yanpeng, Zhang Dahong

Erschienen in: Lasers in Medical Science | Ausgabe 6/2021

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Abstract

The benefit of transurethral laser prostatectomy over open simple prostatectomy (OSP) is controversial in aged symptomatic benign prostatic hyperplasia (BPH) patients with large volume prostates, and the aim of this study is to compare the safety and efficiency of these two methods. Meta-analysis was applied using the Review Manager V5.3 software and the retrieved randomized controlled clinical trials (RCTs) comparing transurethral laser prostatectomy with OSP were analyzed for the treatment of large volume prostates from 2000 to 2019 in PubMed, Web of Science, Cochrane, and EMBASE datasets. Five RCTs assessing transurethral laser prostatectomy versus OSP were considered suitable for this meta-analysis, which included a total of 448 patients, with 232 patients undergoing laser and 216 patients undergoing OSP. Compared with OSP, although transurethral laser prostatectomy required a longer operative time (weighted mean difference (WMD) 27.49 mins; 95% confidence interval (CI) 16.54–38.44; P < 0.00001) and obtained a less resected prostate weight (WMD − 11.72 g; 95% CI − 21.75 to − 1.70; P = 0.02), patients undergoing laser prostatectomy benefited from significantly less hemoglobin decline (− 0.97 g/dL; 95% CI − 1.31 to − 0.64; P < 0.00001), shorter time of catheterization (WMD − 3.67 days; 95% CI − 5.60 to − 1.75; P = 0.0002), shorter length of hospital stay (WMD − 4.75 days; 95% CI − 6.57 to − 2.93; P < 0.00001), and less blood transfusion (odds ratio 0.10; 95% CI 0.03 to 0.35; P = 0.0003). During postoperative follow-up, no significant difference was observed between the two groups in IPSS, QoL, Q_max, and PVR. Both transurethral laser prostatectomy and OSP are safe and effective for large prostates that require prostate resection. Taking into account of less blood loss, shorter catheterization time and hospital stay, and less blood transfusion, transurethral laser prostatectomy may be a better treatment for patients with large prostates.

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Titel: Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials
verfasst von: Wei Haibin
Qian Lin
Wu Junxiu
Wang Heng
Zhang Qi
Wang Yanpeng
Zhang Dahong
Publikationsdatum: 12.10.2020
Verlag: Springer London
Erschienen in: Lasers in Medical Science / Ausgabe 6/2021
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-020-03153-5

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

Abstract

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

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