Safety and Efficacy of Thulium Laser Prostatectomy Versus Transurethral Resection of Prostate for Treatment of Benign Prostate Hyperplasia: A Meta-Analysis.

OBJECTIVE: The aim of the present study was to objectively evaluate the safety and efficacy of Thulium laser prostatectmy (TmLRP) versus transurethral resection of prostate (TURP) in treating benign prostate hyperplasia (BPH).

METHODS: Online databases such as Cochrane Library, PubMed, Embase, and Chinese biomedicine literature database were searched by randomized control trial (RCT), quasi-randomized control trial (Q-RCT) and case control study (CCSs) about TmLRP versus TURP for the treatment of BPH. After study selection, assessment and data extraction conducted, Meta-analyses were performed by using the RevMan 5.2 software.

RESULTS: Six studies involving 640 patients were included and the results of follow-up time was 1 year. The results of meta-analyses showed that: (i) safety indicators: compared with TURP, TmLRP was associated with less decrease of serum sodium salt, less blood transfusion, shorter catheterization time hospital time and more operation time. No differences were noted in the TUR syndrome, recatheterization rate, transitory urge incontinence, stress incontinence urethral stricture and retrograde ejaculation. (ii) Efficacy indicators (International Prostate Symptom Score [IPSS], post-void residual [PVR], Qmax, quality of life [QoL]): Compared with the baseline, significant improvement in IPSS, QoL, Qmax and PVR were obvious improvement before and after surgery in both groups. There were statistical differences in IPSS at 12 months, QoL at 1, 6 months and Qmax 1, 6 months between the two groups.

CONCLUSIONS: TmLRP is a safe and effective procedure for treatment of benign prostatic hyperplasia. Compared with TURP, TmLRP was not only associated with less decrease of serum sodium salt, less blood transfusion, shorter catheterization time and hospital time, but also may be superior to TURP in efficacy.