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The following is a summary of “A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization,” published in the April 2024 issue of Urology by Wang et al. 

Researchers conducted a retrospective study to compare photoselective greenlight vaporization (PVP) and holmium laser enucleation of the prostate (HoLEP) for treating benign prostatic hyperplasia.  

They searched databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) for studies evaluating HoLEP or PVP outcomes published until May 2022. They analyzed complication incidences and postoperative outcomes, including international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels. 

The results showed that 11 studies involving 4763 patients confirmed HoLEP’s superior outcomes compared to PVP. Significant differences in postoperative Qmax were observed at 1 month (MD, 3.31, 95% CI, 0.45–6.16, P = 0.02, I2 = 92%), 3 months (MD, 2.78, 95% CI, 0.53 to 5.02, P = 0.02, I2 = 89%), 6 months (MD, 2.13, 95% CI, 1.11 to 3.15, P < 0.0001, I2 = 87%), and 12 months (MD, 3.98, 95% CI, 2.06 to 5.89, P < 0.0001, I2 = 58%). Severe complication rates were significantly lower in the HoLEP group (odds ratio (OR), 0.05, 95% CI, 0.01 to 0.28, P = 0.0005). 

They found that HoLEP and PVP showed comparable outcomes in most perioperative factors, but HoLEP demonstrated better long-term Qmax, lower energy expenditure, and fewer high-grade complications. Further long-term studies and randomized controlled trials were needed to verify these findings. 

Source: journals.lww.com/cur/fulltext/9900/a_meta_analysis_comparing_treatment_of_benign.161.aspx