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Thulium laser versus standard transurethral resection of the prostate for benign prostatic obstruction: a systematic review and meta-analysis

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Abstract

Purpose

To assess the efficacy and safety of thulium laser versus standard transurethral resection of the prostate (TURP) for treating patients with benign prostatic obstruction.

Methods

A systematic search of the electronic databases, including Medline, Embase, Web of Science, and The Cochrane Library, was performed up to February 1, 2014. The pooled estimates of demographic and clinical baseline characteristics, perioperative variables, complications, and postoperative efficacy including International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR) were calculated.

Results

Seven trials assessing thulium laser versus standard TURP were considered suitable for meta-analysis including four randomized controlled trials (RCTs) and three non-RCTs. Compared with TURP, although thulium laser prostatectomy (TmLRP) needed a longer operative time [weighted mean difference (WMD) 8.18 min; 95 % confidence interval (CI) 1.60–14.75; P = 0.01], patients having TmLRP might benefit from significantly less serum sodium decreased (−3.73 mmol/L; 95 % CI −4.41 to −3.05; P < 0.001), shorter time of catheterization (WMD −1.29 days; 95 % CI −1.95 to −0.63; P < 0.001), shorter length of hospital stay (WMD −1.83 days; 95 % CI −3.10 to −0.57; P = 0.005), and less transfusion (odds ratio 0.09; 95 % CI 0.02–0.41; P = 0.002). During the 1, 3, and, 12 months of postoperative follow-up, the procedures did not demonstrate a significant difference in IPSS, QoL, Qmax, and PVR.

Conclusions

TmLRP had a similar efficacy to standard TURP in terms of IPSS, QoL, Qmax, and PVR, and offered several advantages over TURP in terms of blood transfusion, serum sodium decreased, catheterization time, and hospital stay, while TURP was superior in terms of operation duration. Well-designed multicentric/international RCTs with long-term follow-up are still needed.

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References

  1. Bushman W (2009) Etiology, epidemiology and natural history of benign prostatic hyperplasia. Urol Clin North Am 36(4):403–415

    Article  PubMed  Google Scholar 

  2. Zhuo J, Xia SJ (2013) Is it necessary and feasible to increase the efficiency of 2-µm thulium laser resection of the prostate? Asian J Androl 15(4):453–454

    Article  PubMed Central  PubMed  Google Scholar 

  3. Zhuo J, Wei HB et al (2014) Two-micrometer thulium laser resection of the prostate-tangerine technique for patients with acute urinary retention. Lasers Med Sci 29(3):1093–1098

    Article  PubMed  Google Scholar 

  4. Fried NM (2005) High-power laser vaporization of the canine prostate using a 110 W Thulium fiber laser at 1.91 micron. Lasers Surg Med 36(1):52–56

    Article  PubMed  Google Scholar 

  5. Fried NM, Murray KE (2005) High-power thulium fiber laser ablation of urinary tissues at 1.94 microm. J Endourol 19:25–31

    Article  PubMed  Google Scholar 

  6. Xia SJ, Zhang YN, Lu J et al (2005) Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia. Nat Med J China 85(45):3225–3228

    Google Scholar 

  7. Xia SJ (2009) Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment. Asian J Androl 11:277–281

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Xia SJ, Zhuo J, Sun XW et al (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53(2):382–389

    Article  PubMed  Google Scholar 

  9. Bach T, Xia SJ, Yang Y et al (2010) Thulium:YAG 2 lm cw laser prostatectomy: where do we stand? World J Urol 28(2):163–168

    Article  CAS  PubMed  Google Scholar 

  10. Wei HB, Shao Y, Sun F et al (2014) Thulium laser resection versus plasmakinetic resection of prostates larger than 80 ml. World J Urol 32(4):1077–1085

  11. Wei HB, Zhuo J, Sun XW et al (2014) Safety and efficiency of thulium laser prostate resection for the treatment of benign prostatic hyperplasia in large prostates. Lasers Med Sci 29(3):957–963

    Article  PubMed  Google Scholar 

  12. Cui D, Sun F, Zhuo J et al (2014) A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results. World J Urol 32(3):683–689

    Article  PubMed  Google Scholar 

  13. Fu WJ, Zhang X, Yang Y et al (2010) Comparison of 2-microm continuous wave laser vaporesection of the prostate and transurethral resection of the prostate: a prospective nonrandomized trial with 1-year follow-up. Urology 75(1):194–199

    Article  PubMed  Google Scholar 

  14. Paweł Świniarski P, Stępień S, Dudzic W et al (2012) Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP): evaluation of early results. Cent Eur J Urol 65(3):130–134

    Google Scholar 

  15. Shao JK, Wang YB, Lü YA, Li XD (2012) Comparison of 2 µm continuous-wave laser enucleation of the prostate and transurethral resection of the prostate for benign prostatic hyperplasia. Zhonghua Wai Ke Za Zhi. 50(2):131–134

    PubMed  Google Scholar 

  16. Yan H, Ou TW, Chen L et al (2013) Thulium laser vaporesection versus standard transurethral resection of the prostate: a randomized trial with transpulmonary thermodilution hemodynamic monitoring. Int J Urol 20(5):507–512

    Article  PubMed  Google Scholar 

  17. Zhuo J, Xia SJ, Liu HT et al (2007) A comparative study of thulium laser resection of the prostate-Tangerine technique and transurethral resection of the prostate for the treatment of benign prostatic hyperplasia. Chin J Urol 01:38–41

    Google Scholar 

  18. Wells GA, Shea B, O’Connell D et al (2009) The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed 19 Oct 2009

  19. Clarke M, Horton R (2001) Bringing it all together: lancet-Cochrane collaborate on systematic reviews. Lancet 357:1728

    Article  CAS  PubMed  Google Scholar 

  20. Xu Y, Sun DC, Yang Y et al (2013) 5-year follow-up to transurethral vaporesection of the prostate using the 2 micron continuous wave laser for the treatment of benign prostatic hyperplasia. Zhonghua Wai Ke Za Zhi. 51(2):119–122

    PubMed  Google Scholar 

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Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Urology, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, No.100, Haining Road, Shanghai, 200080, People’s Republic of China

    Yiping Zhu, Jian Zhuo, Dongliang Xu & Shujie Xia

  2. Department of Urology and Urological Oncology, Hanover Medical School (MHH), Carl Neuberg Str. 1, 30625, Hanover, Germany

    Thomas R. W. Herrmann

Authors
  1. Yiping Zhu
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  2. Jian Zhuo
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  3. Dongliang Xu
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  4. Shujie Xia
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  5. Thomas R. W. Herrmann
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Corresponding authors

Correspondence to Dongliang Xu, Shujie Xia or Thomas R. W. Herrmann.

Additional information

Yiping Zhu and Jian Zhuo have contributed equally to this work.

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Zhu, Y., Zhuo, J., Xu, D. et al. Thulium laser versus standard transurethral resection of the prostate for benign prostatic obstruction: a systematic review and meta-analysis. World J Urol 33, 509–515 (2015). https://doi.org/10.1007/s00345-014-1410-6

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  • DOI: https://doi.org/10.1007/s00345-014-1410-6

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