Background:We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization(PVP)versus holmium laser enucleation of the prostate(HoLEP).Methods:Databases(PubMed,...Background:We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization(PVP)versus holmium laser enucleation of the prostate(HoLEP).Methods:Databases(PubMed,Embase,Cochrane Library,Chinese CBM,and CNKI)were searched for eligible studies evaluating HoLEP or PVP outcomes,published until May 2022.We analyzed the incidence of relative complications and postoperative outcomes,including the international prostate symptomscore,maximum flow rate(Qmax),postvoid residual urine volume,quality of life index,and prostate-specific antigen levels.Results:Eleven studies involving 4763 patients were included in thismeta-analysis.The significant differences in postoperativeQmax at 1 month(mean difference[MD],3.31,95% confidence interval[CI],0.45-6.16,p=0.02,I^(2),92%),3 months(MD,2.78,95%CI,0.53-5.02,p=0.02,I^(2),89%),6 months(MD,2.13,95%CI,1.11-3.15,p<0.0001,I^(2),87%),and 12 months(MD,3.98,95%CI,2.06-5.89,p<0.0001,I^(2),58%)further confirmed unique advantage of HoLEP over PVP.We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups(odds ratio,0.05,95%CI,0.01 to 0.28,p=0.0005).Conclusions:Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores,quality of life index,postvoid residual urine volumes,prostate-specific antigen levels,perioperative factors,and total complication rates.Compared with PVP,HoLEP had a greater Qmax 1 year postoperatively,decreased energy expenditure,and fewer high-grade complications.These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.展开更多
文摘Background:We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization(PVP)versus holmium laser enucleation of the prostate(HoLEP).Methods:Databases(PubMed,Embase,Cochrane Library,Chinese CBM,and CNKI)were searched for eligible studies evaluating HoLEP or PVP outcomes,published until May 2022.We analyzed the incidence of relative complications and postoperative outcomes,including the international prostate symptomscore,maximum flow rate(Qmax),postvoid residual urine volume,quality of life index,and prostate-specific antigen levels.Results:Eleven studies involving 4763 patients were included in thismeta-analysis.The significant differences in postoperativeQmax at 1 month(mean difference[MD],3.31,95% confidence interval[CI],0.45-6.16,p=0.02,I^(2),92%),3 months(MD,2.78,95%CI,0.53-5.02,p=0.02,I^(2),89%),6 months(MD,2.13,95%CI,1.11-3.15,p<0.0001,I^(2),87%),and 12 months(MD,3.98,95%CI,2.06-5.89,p<0.0001,I^(2),58%)further confirmed unique advantage of HoLEP over PVP.We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups(odds ratio,0.05,95%CI,0.01 to 0.28,p=0.0005).Conclusions:Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores,quality of life index,postvoid residual urine volumes,prostate-specific antigen levels,perioperative factors,and total complication rates.Compared with PVP,HoLEP had a greater Qmax 1 year postoperatively,decreased energy expenditure,and fewer high-grade complications.These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.
