PD5-06 EVALUATION OF LASER ENUCLEATION TECHNIQUES IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II1 Apr 2015PD5-06 EVALUATION OF LASER ENUCLEATION TECHNIQUES IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS Sam Chopra, Cindy Garcia, Venu Chalasani, and Henry Woo Sam ChopraSam Chopra More articles by this author , Cindy GarciaCindy Garcia More articles by this author , Venu ChalasaniVenu Chalasani More articles by this author , and Henry WooHenry Woo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.305AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study was to conduct a systematic review and meta-analysis of available level 1 evidence studies, to evaluate the efficacy and safety of Laser enucleation techniques versus transurethral resection of prostate (TURP) and OP (open simple prostatectomy). Outcomes analysed were peri-operative complications, and functional outcomes at 12 months. METHODS A systematic literature search was performed using the electronic databases of EMBASE, Medline, and the Cochrane Central Register of Controlled Trials (1991to May2014) and American Urological Association and European Association of Urology conference proceedings from 2010 to 20114 were searched. There were no language restrictions. Trials were included if they were randomised controlled trials, had Laser enucleation (all power machines and any type of laser) as the intervention, and TURP or OP (standard group) as control. Meta-analysis was performed using a random effects model. Risk of bias of enrolled trials was assessed according to Cochrane Handbook. RESULTS A total of 15 RCTs (1628 enrolled patients) were included. Types of Laser used for enucleation included HOLEP, THULEP and Eraser enucleation (ELEP). Immediate complications were less numerous with Laser enucleation arm The rate of acute urinary retention, clot retention, re-catheterization, short-term reoperation, postoperative UTIs, post-operative storage symptoms, and urethral strictures were not significantly different in the two groups. Overall, length of stay was shorter in the laser group -47.8 hours [-59.19, -36.42]; p<00001 (favours Laser) and the rate of blood transfusion significantly less in this group as well (risk ratio: 0.23 [0.1-0.52]; p=0.0005). CONCLUSIONS The results of this systematic review have shown that perioperative outcomes, such as catheterisation time and length of hospital stay were significantly shorter in the laser enucleation arm in comparison to conventional TURP and OP. Postoperative complications of blood transfusion and clot retention were significantly less likely in laser arm. Overall, no difference was noted in intermediate-term functional outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e94 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sam Chopra More articles by this author Cindy Garcia More articles by this author Venu Chalasani More articles by this author Henry Woo More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...