Document Detail


Photoselective green-light laser vaporisation vs. TURP for BPH: meta-analysis.
MedLine Citation:
PMID:  22902908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study sought to evaluate the efficacy and safety of photoselective vaporisation (PVP) vs. transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia (BPH). Eligible studies were identified from electronic databases (Cochrane Library, PubMed and EMBASE). The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy (primary outcomes: maximum urinary flow rate (Q(max)), international prostate symptom score (IPSS), postvoid residual urine (PVR) and quality of life (QoL); secondary outcomes: operative time, hospital time and catheter removal time) and safety (complications, such as transfusion and capsular perforation) were explored by using Review Manager 5.0. Six randomized controlled trials (RCTs) and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in IPSS, Q(max), QoL or PVR between PVP and TURP (mean difference (MD): prostate sizes <70 ml, Q(max) at 24 months, MD=0.01, P=0.97; IPSS at 12 months, MD=0.18, P=0.64; QoL at 12 months, MD=-0.00, P=0.96; PVR at 12 months, MD=0.52, P=0.43; prostate sizes >70 ml, Q(max) at 6 months, MD=-3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0.36; PVR at 6 months, MD=25.50, P=0.39). PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes <70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes <70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether different energy settings affect outcomes.
Authors:
Hui Ding; Wan Du; Ze-Ping Lu; Zhen-Xing Zhai; Han-Zhang Wang; Zhi-Ping Wang
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2012-08-20
Journal Detail:
Title:  Asian journal of andrology     Volume:  14     ISSN:  1745-7262     ISO Abbreviation:  Asian J. Androl.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-04     Completed Date:  2013-01-22     Revised Date:  2013-09-17    
Medline Journal Info:
Nlm Unique ID:  100942132     Medline TA:  Asian J Androl     Country:  China    
Other Details:
Languages:  eng     Pagination:  720-5     Citation Subset:  IM    
Affiliation:
Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, The Second Hospital of Lanzhou University, Lanzhou 730000, China.
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MeSH Terms
Descriptor/Qualifier:
Humans
Laser Therapy*
Male
Prostatectomy / methods*
Prostatic Hyperplasia / physiopathology,  surgery*
Quality of Life
Treatment Outcome
Comments/Corrections

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