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photoselective green-light laser vaporisation vs. TURP for BPH. meta-analysis

Asian Journal of Andrology 2012年第5期14卷 720-725页

作者： Hui Ding Wan Du Ze-Ping Lu Zhen-Xing Zhai Han-Zhang Wang Zhi-Ping Wang Institute of Urology Key Laboratory of Urological Diseases in Gansu ProvinceGansu Nephro-Urological Clinical CenterThe Second Hospital of Lanzhou UniversityLanzhou 730000China Otolaryngological Department The Second Hospital of Lanzhou UniversityLanzhou 730000China The Medical College of Shandong University Jinan 250000China

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 （Qmax）, 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 I PSS, Qmax, QoL or PVR between PVP and TU RP （mean difference （MD）： prostate sizes 〈 70 ml, Qmax 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, Qmax at 6 months, MD=-3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0o36; 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

关键词： benign prostatic hyperplasia (BPH) meta-analysis photoselective vaporisation transurethral resection of the prostate(TURP)

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