Comparison laser anatomical endoscopic enucleation of the prostate (LAEEP) and transurethral resection of the prostate (TURP) in BPH treatment: A meta-analysis

Introduction

Laser anatomical endoscopic enucleation of the prostate (LAEEP) is one of the alternative surgical procedures other than TURP for benign prostate hyperplasia (BPH). However, the consideration for clinical practice needs evidence in terms of efficacy and safety. Our meta-analysis based on the existing studies is to evaluate the efficacy and safety of the LAEEP and TURP for BPH treatment.

Materials and methods

Published randomized controlled trials (RCTs) were identified from PubMed, Science Direct, and Cochrane Library up to December 2021. The meta-analysis was performed by the requirements of PRISMA and after methodological quality assessment, the data was proceeded by RevMan V.5.4.

Results

15 studies were identified with total of 733 patients who underwent LAEEP and 698 patients underwent TURP. There was no significant difference in IPSS at 1,3,6 month but at 12 months significantly better in LAEEP (MD ​= ​−0.43 [-0.81, −0.05] P ​= ​0.03). At 6 and 12 months, the PVR data showed significantly lower in LAEEP (MD ​= ​−4.07 [-6.07, −2.07] P ​< ​0.0001). QoL, Qmax, and IIEF-5 scores were no significant difference in both procedures. Duration of catheterization (MD ​= ​−25.01 [-30.47, −19.55] P ​= ​0.00001) and hospital stay (MD ​= ​−30.26 [-40.71, −19.82] P ​= ​0,00001) were significantly shorter in LAEEP. Operative duration was significantly shorter in TURP (MD ​= ​14.69 [8.64, 20.75] P ​= ​0.00001) but prostate specimen weight result was significantly higher in LAEEP procedure (MD ​= ​4.77 [0.36, 9.17] P ​= ​0.03). Hb drop level (MD ​= ​−0.58 [-0.85, −0.30] P ​= ​0.0001), transfusion rate (OR ​= ​0.37 [0.17, 0.84] P ​= ​0.02) and UTI (OR ​= ​0.35 [0.17, 0.71] P ​= ​0.004) were significantly fewer in LAEEP. However, dysuria events less occurred in TURP (OR ​= ​2.45 [1.51, 3.97] P ​= ​0.0003).

Conclusion

Compared with TURP, LAEEP showed better efficacy and safety with fewer hematological changes and complications, except for operative duration, dysuria events were better in TURP. LAEEP showed other advantages in shorter catheterization time and hospital stay.