A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization  

作　　者：Zhichao Wang Zicheng Tan Mengzhen Qiu Longyang Zhang 

机构地区：[1]Department of Urology,Jinan Central Hospital,Shandong University,Jinan,China [2]Department of Urology,Jinan Central Hospital,Shandong Second Medical University,Jinan,China [3]Department of Urology,Central Hospital Affiliated to Shandong First Medical University,Jinan,China

出　　处：《Current Urology》2025年第1期17-29,共13页当代泌尿学(英文)

摘　　要：Background:We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization(PVP)versus holmium laser enucleation of the prostate(HoLEP).Methods:Databases(PubMed,Embase,Cochrane Library,Chinese CBM,and CNKI)were searched for eligible studies evaluating HoLEP or PVP outcomes,published until May 2022.We analyzed the incidence of relative complications and postoperative outcomes,including the international prostate symptomscore,maximum flow rate(Qmax),postvoid residual urine volume,quality of life index,and prostate-specific antigen levels.Results:Eleven studies involving 4763 patients were included in thismeta-analysis.The significant differences in postoperativeQmax at 1 month(mean difference[MD],3.31,95% confidence interval[CI],0.45-6.16,p=0.02,I^(2),92%),3 months(MD,2.78,95%CI,0.53-5.02,p=0.02,I^(2),89%),6 months(MD,2.13,95%CI,1.11-3.15,p<0.0001,I^(2),87%),and 12 months(MD,3.98,95%CI,2.06-5.89,p<0.0001,I^(2),58%)further confirmed unique advantage of HoLEP over PVP.We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups(odds ratio,0.05,95%CI,0.01 to 0.28,p=0.0005).Conclusions:Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores,quality of life index,postvoid residual urine volumes,prostate-specific antigen levels,perioperative factors,and total complication rates.Compared with PVP,HoLEP had a greater Qmax 1 year postoperatively,decreased energy expenditure,and fewer high-grade complications.These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.

关 键 词：Benign prostatic hyperplasia Holmium laser enucleation META-ANALYSIS Photoselective greenlight vaporization REINTERVENTION 

分 类 号：R69[医药卫生—泌尿科学]