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Holmium laser enucleation versus simple prostatectomy for treating large prostates: Results of a systematic review and meta-analysis
- Source :
- Arab Journal of Urology
- Publication Year :
- 2016
- Publisher :
- Informa UK Limited, 2016.
-
Abstract
- Objective To compare and evaluate the safety and efficacy of holmium laser enucleation of the prostate (HoLEP) and simple prostatectomy for large prostate burdens, as discussion and debate continue about the optimal surgical intervention for this common pathology. Materials and methods A systematic search was conducted for studies comparing HoLEP with simple prostatectomy [open (OP), robot-assisted, laparoscopic] using a sensitive strategy and in accordance with Cochrane collaboration guidelines. Primary parameters of interest were objective measurements including maximum urinary flow rate (Qmax) and post-void residual urine volume (PVR), and subjective outcomes including International Prostate Symptom Score (IPSS) and quality of life (QoL). Secondary outcomes of interest included volume of tissue retrieved, catheterisation time, hospital stay, blood loss and serum sodium decrease. Data on baseline characteristics and complications were also collected. Where possible, comparable data were combined and meta-analysis was conducted. Results In all, 310 articles were identified and after screening abstracts (114) and full manuscripts (14), three randomised studies (263 patients) were included, which met our pre-defined inclusion criteria. All these compared HoLEP with OP. The mean transrectal ultrasonography (TRUS) volume was 113.9 mL in the HoLEP group and 119.4 mL in the OP group. There was no statistically significant difference in Qmax, PVR, IPSS and QoL at 12 and 24 months between the two interventions. OP was associated with a significantly shorter operative time (P = 0.01) and greater tissue retrieved (P
- Subjects :
- medicine.medical_specialty
Urology
medicine.medical_treatment
LASP, laparoscopic simple prostatectomy
Enucleation
030232 urology & nephrology
Holmium laser
WMD, weighted mean difference
chemistry.chemical_element
Qmax, maximum urinary flow rate
law.invention
Holmium
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Prostate
law
medicine
RASP, robot-assisted simple prostatectomy
RCT, randomised controlled trial
HoLEP
Prostatectomy
MeSH, Medical Subject heading
business.industry
Lasers
PVR, post-void residual urine volume
OP, open prostatectomy
QoL, quality of life
Surgery
medicine.anatomical_structure
chemistry
HoLEP, holmium enucleation of the prostate
BPH
030220 oncology & carcinogenesis
Meta-analysis
Prostatic Disorders Review
business
Open Prostatectomy
Subjects
Details
- ISSN :
- 2090598X
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Arab Journal of Urology
- Accession number :
- edsair.doi.dedup.....c2705269d41669e5c3745d4f73005740