Photoselective vaporization with the green light laser vs transurethral resection of the prostate for treating benign prostate hyperplasia: a systematic review and meta-analysis

What's known on the subject? and What does the study add? Despite high morbidities, TURP is still considered as the gold standard' for treatment of BPH. Photoselective vaporization of the prostate (PVP) is a promising technique that is emerging as a possible alternative to TURP. However, there remains some debate about the advantages of PVP over TURP and whether PVP will be able to replace TURP as the first-line surgical treatment. We conducted a meta-analysis of recent papers on this subject and herein provide the overall efficacy and safety of PVP for treatment of BPH. Objective To assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) vs transurethral resection of the prostate (TURP) for treating patients with lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH). Patients and Methods A systematic search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library, as well as manual bibliography searches were performed. The pooled estimates of maximum flow rate (Qmax), postvoid residual (PVR), quality of life (QoL), International Prostate Symptom Score (IPSS), operation duration, blood loss, catheterization time, hospital stay, capsule perforation, transfusion, transurethral resection (TUR) syndrome, urethral stricture and reintervention were calculated. Results At the 3-month follow-up, there was no significant difference in Qmax, PVR, QoL and IPSS between the TURP and PVP groups. At the 6-month follow-up, the pooled QoL favoured TURP, but there was no significant difference in the other variables between the two groups. PVP was associated with less blood loss, transfusion, capsular perforation, TUR syndrome, shorter catheterization time and hospital stay, but longer operation duration and higher reintervention rate. Conclusions The efficacy of PVP was similar to that of TURP in relation to Qmax, PVR, QoL and IPSS, and it offered several advantages over TURP. As a promising minimal invasive technique, PVP could be used as an alternative surgical procedure for treating BPH.