Complications of GreenLight Laser vs Transurethral Resection of the Prostate for Treatment of Lower Urinary Tract Symptoms: Meta-analysis of Randomized Trials.

To compare perioperative outcomes and complications between GreenLight and transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. A systematic review and random effects meta-analysis of randomized trials comparing GreenLight with TURP was completed. Primary outcomes included periprocedural milestones, 12 predefined complications, Clavien-Dindo class III-V complications, reoperations (all-cause), and a composite of reoperations and readmissions. Metaregression assessed the relationship between patient- and study-level factors with periprocedural outcomes and reoperation rates. The review included 13 randomized trials with 1757 patients (839 GreenLight; 918 TURP). Procedure time was 10 minutes (95% CI: 5 to 15; P <.001) longer with GreenLight, while catheterization time (mean difference = −1.3 days; 95% CI: −1.7 to −0.9; P <.001) and hospital stay (mean difference = −2.1 days; 95% CI: −2.5 to −1.7; P <.001) were shorter. Bleeding-related complications, including clot retention (risk ratio [RR] = 0.12; 95% CI: 0.05 to 0.32; P <.001) and transfusion (RR = 0.26; 95% CI: 0.12 to 0.58; P =.001), as well as sexual dysfunction (RR = 0.66; 95% CI: 0.45 to 0.98; P =.04), were less frequent with GreenLight. All other complications occurred at similar frequencies between groups. The risks of reoperation (RR: 1.17; 95% CI: 0.82 to 1.66; P =.38) and reoperation or readmission (RR: 1.05; 95% CI: 0.76 to 1.44; P =.79) did not differ. GreenLight achieved shorter catheterization times and hospital stays with lower rates of sexual dysfunction and bleeding-related complications compared to TURP. [ABSTRACT FROM AUTHOR]