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Comparison of 532-nm GreenLight HPS laser with 980-nm diode laser vaporization of the prostate in treating patients with lower urinary tract symptom secondary to benign prostatic hyperplasia: a meta-analysis

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Abstract

To evaluate the efficacy and safety of 532-nm GreenLight HPS laser (PVP) vs 980-nm diode laser vaporization of the prostate (DVP) in treating patients with lower urinary tract symptom (LUTS) secondary to benign prostatic hyperplasia (BPH). PubMed, Cochrane Library databases, EMBASE (until Jun 2020), and original references of the included articles were searched. PRISMA checklist was followed. A total of four articles including 521 patients were studied. There was no significant difference in total operating time and lasering time of the two laser surgeries; however, a higher amount of total applied laser energy was delivered with DVP (P < 0.00001). The catheterization time after surgery in the PVP group was significantly longer than that in the DVP group (P = 0.0008), whereas the hospitalization time was significantly shorter than that in the DVP group (P = 0.02). Compared with baseline, there were significant improvements in the voiding variables over the observation period after surgery in both groups. PVP had a significant improvement in total international prostate symptom score (IPSS) (P = 0.0002) and quality of life (QoL) index (P = 0.003) compared with DVP after ≥12 months of postoperative follow-up. For complications after surgery, PVP had a larger number in needing for electrocautery to control bleeding (P = 0.02). Besides, the application of DVP resulted in a higher incidence of bladder neck contracture (P = 0.0007), dysuria (≥1 month) (P = 0.002), transient incontinence (P = 0.003), postoperative recatheterization (P = 0.02), and reoperation (P < 0.0001). The voiding parameters and micturition symptoms of patients with BPH after two kinds of laser surgery were significantly improved. However, PVP was more beneficial than DVP in terms of total IPSS, QoL index, and hospitalization time. Moreover, PVP showed a lower incidence of postoperative adverse events, but a higher risk of postoperative bleeding. PROSPERO registration number: CRD42020203222

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The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Funding

This work was supported by Beijing Municipal Administration of Hospitals’ Ascent Plan, code: DFL20190502; Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, code: ZYLX201820; and National Nature Science Foundation of China, code: 81801429.

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Author notes

  1. Zhongbao Zhou and Yuanshan Cui contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China

    Zhongbao Zhou, Yuanshan Cui & Yong Zhang

  2. Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China

    Yuanshan Cui

  3. Department of Urology, PLA Rocket Force Characteristic Medical Center, NO. 16 Xinwai Street, Xicheng District, Beijing, 100088, China

    Xiaoyi Zhang

Authors
  1. Zhongbao Zhou
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  2. Yuanshan Cui
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  3. Xiaoyi Zhang
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  4. Yong Zhang
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Contributions

Conceptualization: Yong Zhang; methodology: Zhongbao Zhou, Yuanshan Cui; formal analysis and investigation: Zhongbao Zhou, Yuanshan Cui, Xiaoyi Zhang; writing - original draft preparation: Zhongbao Zhou, Yuanshan Cui; writing - review and editing: Xiaoyi Zhang, Yong Zhang; funding acquisition: Yong Zhang; resources: Zhongbao Zhou, Yuanshan Cui; supervision: Yong Zhang, Xiaoyi Zhang.

Corresponding author

Correspondence to Yong Zhang.

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The authors declare no competing interest.

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Supplementary information

Supplementary Figure 2.

Changes in total operating time, lasering time and total applied laser energy. (PNG 405 kb).

High resolution image (TIF 363 kb).

Supplementary Figure 3.

Changes in decrease in serum sodium and decrease in hemoglobin. (PNG 227 kb).

High resolution image (TIF 698 kb).

Supplementary Figure 4.

Results in catheterization time and hospitalization time. (PNG 412 kb).

High resolution image (TIF 2677 kb).

Supplementary Figure 5.

Changes in international prostate symptom score at 1-, 3-, 6-, and ≥12-month after surgery. (PNG 406 kb).

High resolution image (TIF 1205 kb).

Supplementary Figure 6.

Changes in quality of life score at 1-, 3-, 6-, and ≥12-month after surgery. (PNG 405 kb).

High resolution image (TIF 1205 kb).

Supplementary Figure 7.

Changes in maximum flow rate at 1-, 3-, 6-, and ≥12-month after surgery. (PNG 421 kb).

High resolution image (TIF 1248 kb).

Supplementary Figure 8.

Changes in post-void residual urine at 1-, 3-, 6-, and ≥12-month after surgery. (PNG 425 kb).

High resolution image (TIF 1246 kb).

Supplementary Figure 9.

Chart showed the vary of indexes (including IPSS total, Qmax, PVR, QoL score) at 1-, 3-, 6-, and ≥12-month after surgery between PVP and DVP. (PNG 123 kb).

High resolution image (TIF 436 kb).

Supplementary Figure 10.

Changes in prostate volume at 6-month after surgery and prostate specific antigen at 6- and ≥12-month after surgery. (PNG 311 kb).

High resolution image (TIF 1999 kb).

Supplementary Figure 11.

Events in needing for electrocautery to control bleeding, bladder neck contracture and urethral stricture. (PNG 405 kb).

High resolution image (TIF 2636 kb).

Supplementary Figure 12.

Events in urinary tract infection, transient incontinence, dysuria (< 1month) and dysuria (≥1month). (PNG 450 kb).

High resolution image (TIF 2944 kb).

Supplementary Figure 13.

Events in postoperative re-catheterization and reoperation. (PNG 268 kb).

High resolution image (TIF 1750 kb).

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Zhou, Z., Cui, Y., Zhang, X. et al. Comparison of 532-nm GreenLight HPS laser with 980-nm diode laser vaporization of the prostate in treating patients with lower urinary tract symptom secondary to benign prostatic hyperplasia: a meta-analysis. Lasers Med Sci 36, 1897–1907 (2021). https://doi.org/10.1007/s10103-021-03255-8

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  • DOI: https://doi.org/10.1007/s10103-021-03255-8

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