Thulium laser VapoResection of the prostate versus traditional transurethral resection of the prostate or transurethral plasmakinetic resection of prostate for benign prostatic obstruction: a systematic review and meta-analysis
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To compare the efficacy and safety of thulium laser VapoResection of the prostate (ThuVaRP) versus standard traditional transurethral resection of the prostate (TURP) or plasmakinetic resection of prostate (PKRP) for benign prostatic obstruction.
Systematic searches were performed in the Medline, EMBASE, the Cochrane Library, Web of Science, and CNKI in December 2017. The outcomes of demographic and clinical characteristics, perioperative variables, complications, and postoperative efficacy including International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR) were assessed.
16 studies were selected in the meta-analysis including nine randomized controlled trials (RCTs) and seven non-RCTs. Among of them, nine studies compared ThuVaRP with PKRP, while seven studies compared ThuVaRP with TURP. It seemed that ThuVaRP needed longer operation time than TURP (WMD = 6.41, 95% CI 1.38–11.44, p = 0.01) and PKRP (WMD = 10.15, 95% CI 5.20–15.10, p < 0.0001). ThuVaRP was associated with less serum hemoglobin decreased, catheterization time, and the length of hospital stay compared with TURP (WMD = − 0.58, 95% CI − 0.77 to 0.38, p < 0.00001; WMD = − 1.89, 95% CI − 2.67 to 1.11, p < 0.00001; WMD = − 2.25, 95% CI − 2.91 to 1.60, p < 0.00001) and PKRP (WMD = − 0.28, 95% CI − 0.46 to 0.10, p = 0.002; WMD = − 1.88, 95% CI − 2.87 to 0.89, p = 0.0002; WMD = − 2.08, 95% CI − 2.63 to 1.54, p<0.00001). According to our assessment, there was no significantly difference in postoperative efficacy.
The pooled data indicated that ThuVaRP had a nearly efficacy to TURP and PKRP based on IPSS, QoL, Qmax, and PVR. Although ThuVaRP was associated with longer operation time, it got distinct superiority on serum hemoglobin decreased, catheterization time, and hospital stay.
KeywordsThulium laser VapoResection of the prostate, Transurethral resection of the prostate, Plasmakinetic resection of prostate, Benign prostatic obstruction, 2-micron Thulium laser, Safety and efficacy
This work was supported by grants from the National Nature Science Foundation of China (No. 81400755).
Deng and Sun: project development, data collection, data analysis, and manuscript writing. These two first authors contributed equally to this meta-analysis. Zhu, Zhuo, and Zhao: data analysis. Xia, Han, and Hermann: project development
Compliance with ethical standards
All included studies have reported institutional ethical approval.
Research involving human participants and/or animals
All included studies involving human participants.
Conflict of interest
No competing financial interests exist.
Formal consent is not required for meta-analysis.
- 1.Martin SA, Haren MT, Marshall VR, Lange K, Wittert GA, S. Members of the Florey Adelaide Male Ageing (2011) Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World J Urol 29(2):179–184CrossRefPubMedGoogle Scholar
- 3.Kupelian V, Wei JT, O’Leary MP, Kusek JW, Litman HJ, Link CL et al (2006) Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med 166(21):2381–2387CrossRefPubMedGoogle Scholar
- 11.Xia SJ, Zhang YN, Lu J et al (2005) Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia. Nat Med J China 45:62–65Google Scholar
- 16.Luo B, Zhao X, Lu L et al (2013) The comparison of 2 microns laser five points method vaporization resection and plasma bipolar electrotomy for curative effect of high-risk prostatic hyperplasia. China J Endosc 02:155–157Google Scholar
- 17.Hou Y, He Y, Wang H, Zhu W (2016) Thulium laser VapoResection of prostate versus transurethral plasmakinetic resection of prostate for aged and high-risk. Chin J Gerontol 08:1939–1940Google Scholar
- 18.Liu C, Li N, Liu Y, Wang P (2011) Thulium laser VapoResection of prostate versus transurethral plasmakinetic resection of prostate for BPH patients. Chin J Laser Med Surg 02:102–105Google Scholar
- 19.Sun Y, Luo G, Sun Z et al (2011) A comparative study on the results of two micron laser VapoResection of prostate and bipolar transurethral plasmakinetic prostatectomy for benign prostatic hyperplasia. China J Endosc 07:687–691Google Scholar
- 20.Sheng Yang, Jia Liu, Jun Zhang (2015) Comparison of 2 μm continuous-wave laser VapoResection and transurethral resection of the prostate: a randomized controlled trial. Chin J Min Inv Surg 11:986–989Google Scholar
- 21.Zhang C, Liu Z, Hu L, Bai Z, Li X, Huang Y (2009) Comparative study on 2 μm continuous wave laser VapoResection of the prostate and transurethral electrovaporization resection of prostate in treatment of BPH. Mod Prev Med 16:3185–3186Google Scholar
- 22.Kim JW, Kim YJ, Lee YH, Kwon JB, Cho SR, Kim JS (2014) An analytical comparison of short-term effectiveness and safety between thulium:yag laser VapoResection of the prostate and bipolar transurethral resection of the prostate in patients with benign prostatic hyperplasia. Korean J Urol 55(1):41–46CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Jia Z (2009) Control study on thulium laser orange -decorticating type of prostatectomy with transurethral prostatic electric resection to treat patients with benign prostatic hyperplasia. Chin Nurs Res 09:792–793Google Scholar
- 28.Tai S, Fan W, Zhong D, Wang K (2015) Thulium laser transurethral resection of prostate versus transurethral resection of prostate. Clin Educ General Pract 03:314–316Google Scholar