Efficacy and safety of transurethral bipolar plasmakinetic prostatectomy versus holmium laser enucleation of the prostate for treatment of benign prostatic hyperplasia: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WENG Hong ¹ , ZENG Xiantao ¹ , REN Xuanyi ² , LV Dong ² ,  WANG Xinghuan ¹ , on behalf of the BPSC investigators

1. Department of Urology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University; Center for Evidence-Based and Translational Medicine, Wuhan University; Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical Medical College of Wuhan University, Wuhan, 430071, P.R.China;
2. Department of Urology, Kaifeng Central Hospital, Kaifeng, 475000, P.R.China;

Corresponding author：

WANG Xinghuan, Email: wangxinghuan1965@163.com

Keywords：

Transurethral bipolar plasmakinetic prostatectomy; Holmium laser enucleation of the prostate; Benign prostatic hyperplasia; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201803054

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ObjectivesTo systematically evaluate the efficacy and safety of the transurethral bipolar plasmakinetic prostatectomy (TUPKP) versus holmium laser enucleation of the prostate (HoLEP) for treatment of benign prostatic hyperplasia (BPH).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of TUPKP and HoLEP for treatment of BPH from inception to January 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, the meta-analyses were performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 784 patients were included. The results of meta-analyses showed that, in efficacy outcomes, TUPKP was superior to HoLEP in Q_max at 48 months, and was inferior to HoLEP in PVR at 3 months, Q_max in 60 and 72 months, and IIEF-5 at 48 and 72 months. No significant association was found between two groups in Q_max from 1 to 36 months, IPSS from 1 to 72 months, prostate volume, PVR from 6 months, IIEF-5 from 1 to 24 months, QoL at 1 to 36 months, and resected prostate weight. As for safety, TUPKP was superior to HoLEP in operation time, while inferior to HoLEP in blood loss during procedure, hospital stay, catheterization period, bladder irrigation period, irrigation fluid, massive hemorrhage and hematuresis. No significant association was observed between two groups in serum sodium decrease, hemoglobin decrease, PSA, postoperative urine retention, blood transfusion, cystospasm, temporary incontinence, urinary tract infection, TURS, epididymitis, temporary difficulty in urination, urinary tract irritation syndrome, reoperation, retrograde ejaculation, urinary incontinence, ED and urethrostenosis.ConclusionsCurrent evidence shows that the efficacy and safety of TUPKP and HoLEP for treatment of BPH are similar. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： WENG Hong, ZENG Xiantao, REN Xuanyi, LV Dong, WANG Xinghuan, on behalf of the BPSC investigators. Efficacy and safety of transurethral bipolar plasmakinetic prostatectomy versus holmium laser enucleation of the prostate for treatment of benign prostatic hyperplasia: a systematic review. Chinese Journal of Evidence-Based Medicine, 2018, 18(8): 840-849. doi: 10.7507/1672-2531.201803054 Copy

1.	田野, 邵强, 宋健. 北京多中心社区良性前列腺增生患病率调查: BPC-BPH 研究结果. 中华泌尿外科杂志, 2010, 31(3): 194-198.
2.	于普林, 郑宏, 苏鸿学, 等. 中国六城市老年人前列腺增生的患病率及相关因素. 中华流行病学杂志, 2000, 21(4): 276-279.
3.	韩晓峰, 任江玲, 胡黎明, 等. 甘肃省平凉市良性前列腺增生患病率调查与临床分析. 中华男科学杂志, 2013, 19(4): 324-327.
4.	于宝成, 徐若华, 仲伟红, 等. 军队老年人良性前列腺增生的患病率与代谢综合征的关系. 中华老年医学杂志, 2011, 30(11): 968-969.
5.	张祥华, 王行环, 王刚, 等. 良性前列腺增生临床诊治指南. 中华外科杂志, 2007, 45(24): 1704-1707.
6.	王行环. 良性前列腺增生的微创治疗. 临床外科杂志, 2013, 21(11): 819-821.
7.	王亮, 李黎明, 崔喆, 等. 经尿道前列腺等离子双极电切术与普通电切术中失血量比较. 中华腔镜泌尿外科杂志(电子版), 2009, 3(1): 11-14.
8.	王行环. 经尿道前列腺等离子双极电切术. 医学新知杂志, 2004, 14(1): 8-9.
9.	李胜, 王行环. 等离子体双极电切系统在前列腺增生症手术治疗中的应用及研究进展. 中华临床医师杂志(电子版), 2011, 5(20): 6089-6093.
10.	Gravas S, Bach T, Drake M, et al. Treatment of Non-neurogenic Male LUTS. London: European Association of Urology, 2017. Available at: http://uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/.
11.	吴忠, 丁强, 姜昊文, 等. 经尿道钬激光剜除术治疗良性前列腺增生症. 中华医学杂志, 2006, 86(36): 2560-2562.
12.	王忠, 陈彦博, 陈其, 等. 经尿道前列腺钬激光剜除术治疗良性前列腺增生的疗效研究. 现代泌尿外科杂志, 2013, 18(6): 535-537.
13.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. Cochrane Collaboration, 2011. Available at: www.cochrane-handbook.org.
14.	Bhandarkar A, Pandya S. POD-04.01 Comparing Holmium Laser Enucleation of Prostate (HoLEP) with bipolar transurethral resection of prostate: a prospective randomized controlled trial. Urology, 2011, 78(3): S12-S12.
15.	Choi S, Chung JM. Comparison of clinical results between bipolar TURP and holmium laser enucleation of the prostate (HoLEP) based on the initial experience in patients with obstructive BPH. J Urol, 2012, 187(4): e873-e873.
16.	陈启富, 王德明, 张小滨. 经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生的疗效和安全性对比研究. 中外医疗, 2016, 35(27): 88-90.
17.	王昌忠. 经尿道钬激光剜除术治疗良性前列腺增生的临床观察. 国际泌尿系统杂志, 2016, 36(6): 855-857.
18.	杨宁, 巫嘉文. 不同方式治疗前列腺良性增生疗效与安全性对比. 现代仪器与医疗, 2016, 22(5): 112-114.
19.	张春锋. 经尿道等离子切除术与经尿道钬激光剜除术治疗良性前列腺增生的疗效分析. 中国保健营养, 2016, 26(25): 260-261.
20.	Gu M, Chen YB, Liu C, et al. Comparison of holmium laser enucleation and plasmakinetic resection of prostate: a randomized trial with 72-month follow-up. J Endourol, 2018, 32(2): 139-143.
21.	王建峰, 肇恒飞. 经尿道钬激光剜除术与经尿道等离子切除术治疗良性前列腺增生效果比较. 中国乡村医药, 2017, 24(24): 40-41.
22.	袁宝国, 殷全忠. 经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生对比研究. 实用老年医学, 2017, (4): 356-358.
23.	Zeng XT, Liu TZ, Gong K, et al. The BPSC: A prospective study investigating the clinical effect of interventional therapy and the risk factors for bladder cancer and benign prostatic hyperplasia in Chinese population. J Evid Based Med, 2018, 11(1): 64-67.

1. 田野, 邵强, 宋健. 北京多中心社区良性前列腺增生患病率调查: BPC-BPH 研究结果. 中华泌尿外科杂志, 2010, 31(3): 194-198.
2. 于普林, 郑宏, 苏鸿学, 等. 中国六城市老年人前列腺增生的患病率及相关因素. 中华流行病学杂志, 2000, 21(4): 276-279.
3. 韩晓峰, 任江玲, 胡黎明, 等. 甘肃省平凉市良性前列腺增生患病率调查与临床分析. 中华男科学杂志, 2013, 19(4): 324-327.
4. 于宝成, 徐若华, 仲伟红, 等. 军队老年人良性前列腺增生的患病率与代谢综合征的关系. 中华老年医学杂志, 2011, 30(11): 968-969.
5. 张祥华, 王行环, 王刚, 等. 良性前列腺增生临床诊治指南. 中华外科杂志, 2007, 45(24): 1704-1707.
6. 王行环. 良性前列腺增生的微创治疗. 临床外科杂志, 2013, 21(11): 819-821.
7. 王亮, 李黎明, 崔喆, 等. 经尿道前列腺等离子双极电切术与普通电切术中失血量比较. 中华腔镜泌尿外科杂志(电子版), 2009, 3(1): 11-14.
8. 王行环. 经尿道前列腺等离子双极电切术. 医学新知杂志, 2004, 14(1): 8-9.
9. 李胜, 王行环. 等离子体双极电切系统在前列腺增生症手术治疗中的应用及研究进展. 中华临床医师杂志(电子版), 2011, 5(20): 6089-6093.
10. Gravas S, Bach T, Drake M, et al. Treatment of Non-neurogenic Male LUTS. London: European Association of Urology, 2017. Available at: http://uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/.
11. 吴忠, 丁强, 姜昊文, 等. 经尿道钬激光剜除术治疗良性前列腺增生症. 中华医学杂志, 2006, 86(36): 2560-2562.
12. 王忠, 陈彦博, 陈其, 等. 经尿道前列腺钬激光剜除术治疗良性前列腺增生的疗效研究. 现代泌尿外科杂志, 2013, 18(6): 535-537.
13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. Cochrane Collaboration, 2011. Available at: www.cochrane-handbook.org.
14. Bhandarkar A, Pandya S. POD-04.01 Comparing Holmium Laser Enucleation of Prostate (HoLEP) with bipolar transurethral resection of prostate: a prospective randomized controlled trial. Urology, 2011, 78(3): S12-S12.
15. Choi S, Chung JM. Comparison of clinical results between bipolar TURP and holmium laser enucleation of the prostate (HoLEP) based on the initial experience in patients with obstructive BPH. J Urol, 2012, 187(4): e873-e873.
16. 陈启富, 王德明, 张小滨. 经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生的疗效和安全性对比研究. 中外医疗, 2016, 35(27): 88-90.
17. 王昌忠. 经尿道钬激光剜除术治疗良性前列腺增生的临床观察. 国际泌尿系统杂志, 2016, 36(6): 855-857.
18. 杨宁, 巫嘉文. 不同方式治疗前列腺良性增生疗效与安全性对比. 现代仪器与医疗, 2016, 22(5): 112-114.
19. 张春锋. 经尿道等离子切除术与经尿道钬激光剜除术治疗良性前列腺增生的疗效分析. 中国保健营养, 2016, 26(25): 260-261.
20. Gu M, Chen YB, Liu C, et al. Comparison of holmium laser enucleation and plasmakinetic resection of prostate: a randomized trial with 72-month follow-up. J Endourol, 2018, 32(2): 139-143.
21. 王建峰, 肇恒飞. 经尿道钬激光剜除术与经尿道等离子切除术治疗良性前列腺增生效果比较. 中国乡村医药, 2017, 24(24): 40-41.
22. 袁宝国, 殷全忠. 经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生对比研究. 实用老年医学, 2017, (4): 356-358.
23. Zeng XT, Liu TZ, Gong K, et al. The BPSC: A prospective study investigating the clinical effect of interventional therapy and the risk factors for bladder cancer and benign prostatic hyperplasia in Chinese population. J Evid Based Med, 2018, 11(1): 64-67.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of transurethral bipolar plasmakinetic prostatectomy versus holmium laser enucleation of the prostate for treatment of benign prostatic hyperplasia: a systematic review

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