Enucleation of the prostate for benign prostatic hyperplasia thulium laser versus holmium laser: a systematic review and meta-analysis

  • Kai-Wen Xiao
  • Liang Zhou
  • Qing He
  • Xiao-Shuai Gao
  • Guo Chen
  • Yu-Cheng Ma
  • Hong Li
  • Kun-Jie WangEmail author
Review Article


To evaluate the clinical efficacy and safety of thulium laser vapoenucleation/enucleation of the prostate (ThuEP) versus holmium laser enucleation of the prostate (HoLEP) in the management of benign prostatic hyperplasia (BPH). A systematic literature search was performed using PubMed, Embase, and Web of Science to identify eligible studies published before July 2018. Meta-analysis of extracted data was performed with RevMan version 5.3. We chose the fixed- or random-effect model to fit the pooled heterogeneity. Five eligible studies including two randomized controlled trials (RCTs) and three non-RCTs involving 1010 patients were enrolled in our meta-analysis. ThuEP provided less enucleation time when compared with HoLEP (WMD = − 7.73, 95% CI − 14.39–1.07, P = 0.02). During the 1st, 6th, and 12th months of postoperative follow-ups, statistically significant differences were found in Qmax (WMD = 2.05, 95% CI 0.52~3.58) and PVR (WMD = − 6.50, 95% CI − 7.35~− 5.66, P < 0.001) in the 1st month after the operation, also in IPSS (IPSS: WMD = − 1.29, 95% CI − 2.39~− 0.19, P = 0.02) in the 12th month after the operation. As regards other perioperative, postoperative parameters, and complication rates, we found no significant difference. Both ThuEP and HoLEP provided satisfactory micturition improvement with low morbidity after the 1st and 6th months of the operation. However, ThuEP showed higher enucleation efficacy and less intraoperative blood loss and may get a better outcome as compared to the HoLEP group in the early postoperative period with regard to Qmax/PVR and IPSS after the 1st and 12th months of the operation respectively.


Thulium laser Holmium laser Enucleation Safety Efficacy Meta-analysis 



This study was supported by The National Natural Science Fund of China (81470927), National Natural Science Fund of China (81800667), and 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University.

Compliance with ethical standards

Ethical approval

Meta-analysis does not require ethical review.

Informed consent

Meta-analysis does not require informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10103_2018_2697_MOESM1_ESM.docx (18 kb)
Supplementary Table 1 (DOCX 17 kb)


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  • Kai-Wen Xiao
    • 1
  • Liang Zhou
    • 1
  • Qing He
    • 1
  • Xiao-Shuai Gao
    • 1
  • Guo Chen
    • 1
  • Yu-Cheng Ma
    • 1
  • Hong Li
    • 1
  • Kun-Jie Wang
    • 1
    Email author
  1. 1.Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China HospitalSichuan UniversityChengduPeople’s Republic of China

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