GreenLight photoselective laser vaporisation versus transurethral resection of the prostate for large prostates: systematic review and meta-analysis.

IF 1.7 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2025-05-30 Epub Date: 2025-05-22 DOI:10.21037/tau-2025-111

Breno C Porto, Bianca C Benedicto, Beatriz T Constantinou, Nathalie C Hobaica, Carlo C Passerotti, Richard Dobrucki de Lima, Rodrigo A S Sanderberg, Everson L A Artifon, Jose P Otoch, Jose A S da Cruz

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引用次数: 0

Abstract

Background: Transurethral resection of the prostate (TURP) stands as a primary surgical intervention for benign prostatic hyperplasia (BPH), although laser techniques, notably photoselective vaporisation of the prostate (PVP), are gaining traction. Previous studies have already assessed the efficacy of TURP and PVP, although with small prostates (<70 mL). Thus, this systematic review and meta-analysis aims to assess the efficacy of PVP compared to TURP in the male BPH population with large prostates (≥70 mL).

Methods: A systematic review was conducted across MEDLINE, Embase, Scopus, Web of Science, and Google Scholar. Studies comparing PVP to TURP in male BPH patients were included. Our primary outcome was the International Prostate Symptom Score (IPSS). Secondary outcomes encompassed maximum urinary flow rate (Qmáx), postvoid residual volume (Vres), operative time, catheterization time, postoperative hospital stay and complications. To assess the risk of bias we used Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized studies, and risk of bias 2 tool (Cochrane) (RoB2) for the randomized.

Results: Three articles encompassing 159 patients each in the PVP and TURP groups were included. Our analysis revealed no statistically significant difference in IPSS score between PVP and TURP [mean difference (MD) 1.56; 95% confidence interval (CI): 0.52 to 3.64; P=0.14; I²=85%]. TURP demonstrated a reduced operative time (MD 30.35; 95% CI: 11.26 to 49.44; P=0.002; I²=96%), whereas PVP exhibited shorter catheterization time (MD -2.22; 95% CI: -2.44 to -1.99; P<0.001; I²=1%) and postoperative hospital stay (MD -2.20; 95% CI: -2.69 to -1.72; P<0.001; I²=75%). No significant differences were observed in other outcomes assessed.

Conclusions: This meta-analysis suggests that PVP is non-inferior to TURP concerning IPSS, Qmáx, Vres, and complications, albeit with a longer operative time. PVP showed a reduced catheterization and postoperative hospital stay.

查看原文本刊更多论文

GreenLight光选择性激光汽化与经尿道前列腺切除术治疗大前列腺：系统回顾和荟萃分析。

背景：经尿道前列腺切除术（TURP）是治疗良性前列腺增生（BPH）的主要手术干预手段，尽管激光技术，特别是前列腺光选择性汽化（PVP）正在获得越来越多的关注。先前的研究已经评估了TURP和PVP的疗效，尽管是针对小前列腺(方法：通过MEDLINE， Embase, Scopus， Web of Science和谷歌Scholar进行了系统综述。研究比较PVP和TURP在男性前列腺增生患者中的作用。我们的主要终点是国际前列腺症状评分（IPSS）。次要结局包括最大尿流率（Qmáx）、尿后残留量（Vres）、手术时间、置管时间、术后住院时间和并发症。为了评估偏倚风险，我们对非随机研究使用了非随机干预研究的偏倚风险（ROBINS-I），对随机研究使用了偏倚风险2工具（Cochrane）（RoB2）。结果：纳入PVP组和TURP组各159例的3篇文章。我们的分析显示PVP和TURP之间的IPSS评分无统计学差异[mean difference (MD) 1.56；95%置信区间（CI）： 0.52 ~ 3.64；P = 0.14;I2 = 85%)。TURP显示手术时间缩短(MD 30.35；95% CI: 11.26 ~ 49.44；P = 0.002;I2=96%)，而PVP的置管时间较短(MD -2.22；95% CI: -2.44 ~ -1.99；P2=1%)和术后住院时间(MD -2.20；95% CI: -2.69 ~ -1.72；P2 = 75%)。在评估的其他结果中未观察到显著差异。结论：这项荟萃分析表明PVP在IPSS、Qmáx、Vres和并发症方面不逊于TURP，尽管手术时间更长。PVP减少了插管时间和术后住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.