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

AbstractThe 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...
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research