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

Video：

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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, 邵強, 宋健. 北京多中心社區良性前列腺增生患病率調查: BPC-BPH 研究結果. 中華泌尿外科雜志, 2010, 31(3): 194-198.
2.	于普林, 鄭宏, 蘇鴻學, 等. 中國六城市老年人前列腺增生的患病率及相關因素. 中華流行病學雜志, 2000, 21(4): 276-279.
3.	韓曉峰, 任江玲, 胡黎明, 等. 甘肅省平涼市良性前列腺增生患病率調查與臨床分析. 中華男科學雜志, 2013, 19(4): 324-327.
4.	于寶成, 徐若華, 仲偉紅, 等. 軍隊老年人良性前列腺增生的患病率與代謝綜合征的關系. 中華老年醫學雜志, 2011, 30(11): 968-969.
5.	張祥華, 王行環, 王剛, 等. 良性前列腺增生臨床診治指南. 中華外科雜志, 2007, 45(24): 1704-1707.
6.	王行環. 良性前列腺增生的微創治療. 臨床外科雜志, 2013, 21(11): 819-821.
7.	王亮, 李黎明, 崔喆, 等. 經尿道前列腺等離子雙極電切術與普通電切術中失血量比較. 中華腔鏡泌尿外科雜志(電子版), 2009, 3(1): 11-14.
8.	王行環. 經尿道前列腺等離子雙極電切術. 醫學新知雜志, 2004, 14(1): 8-9.
9.	李勝, 王行環. 等離子體雙極電切系統在前列腺增生癥手術治療中的應用及研究進展. 中華臨床醫師雜志(電子版), 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.	吳忠, 丁強, 姜昊文, 等. 經尿道鈥激光剜除術治療良性前列腺增生癥. 中華醫學雜志, 2006, 86(36): 2560-2562.
12.	王忠, 陳彥博, 陳其, 等. 經尿道前列腺鈥激光剜除術治療良性前列腺增生的療效研究. 現代泌尿外科雜志, 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.	陳啟富, 王德明, 張小濱. 經尿道前列腺等離子切除術與鈥激光剜除術治療良性前列腺增生的療效和安全性對比研究. 中外醫療, 2016, 35(27): 88-90.
17.	王昌忠. 經尿道鈥激光剜除術治療良性前列腺增生的臨床觀察. 國際泌尿系統雜志, 2016, 36(6): 855-857.
18.	楊寧, 巫嘉文. 不同方式治療前列腺良性增生療效與安全性對比. 現代儀器與醫療, 2016, 22(5): 112-114.
19.	張春鋒. 經尿道等離子切除術與經尿道鈥激光剜除術治療良性前列腺增生的療效分析. 中國保健營養, 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, 肇恒飛. 經尿道鈥激光剜除術與經尿道等離子切除術治療良性前列腺增生效果比較. 中國鄉村醫藥, 2017, 24(24): 40-41.
22.	袁寶國, 殷全忠. 經尿道前列腺等離子切除術與鈥激光剜除術治療良性前列腺增生對比研究. 實用老年醫學, 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, 邵強, 宋健. 北京多中心社區良性前列腺增生患病率調查: BPC-BPH 研究結果. 中華泌尿外科雜志, 2010, 31(3): 194-198.
2. 于普林, 鄭宏, 蘇鴻學, 等. 中國六城市老年人前列腺增生的患病率及相關因素. 中華流行病學雜志, 2000, 21(4): 276-279.
3. 韓曉峰, 任江玲, 胡黎明, 等. 甘肅省平涼市良性前列腺增生患病率調查與臨床分析. 中華男科學雜志, 2013, 19(4): 324-327.
4. 于寶成, 徐若華, 仲偉紅, 等. 軍隊老年人良性前列腺增生的患病率與代謝綜合征的關系. 中華老年醫學雜志, 2011, 30(11): 968-969.
5. 張祥華, 王行環, 王剛, 等. 良性前列腺增生臨床診治指南. 中華外科雜志, 2007, 45(24): 1704-1707.
6. 王行環. 良性前列腺增生的微創治療. 臨床外科雜志, 2013, 21(11): 819-821.
7. 王亮, 李黎明, 崔喆, 等. 經尿道前列腺等離子雙極電切術與普通電切術中失血量比較. 中華腔鏡泌尿外科雜志(電子版), 2009, 3(1): 11-14.
8. 王行環. 經尿道前列腺等離子雙極電切術. 醫學新知雜志, 2004, 14(1): 8-9.
9. 李勝, 王行環. 等離子體雙極電切系統在前列腺增生癥手術治療中的應用及研究進展. 中華臨床醫師雜志(電子版), 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. 吳忠, 丁強, 姜昊文, 等. 經尿道鈥激光剜除術治療良性前列腺增生癥. 中華醫學雜志, 2006, 86(36): 2560-2562.
12. 王忠, 陳彥博, 陳其, 等. 經尿道前列腺鈥激光剜除術治療良性前列腺增生的療效研究. 現代泌尿外科雜志, 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. 陳啟富, 王德明, 張小濱. 經尿道前列腺等離子切除術與鈥激光剜除術治療良性前列腺增生的療效和安全性對比研究. 中外醫療, 2016, 35(27): 88-90.
17. 王昌忠. 經尿道鈥激光剜除術治療良性前列腺增生的臨床觀察. 國際泌尿系統雜志, 2016, 36(6): 855-857.
18. 楊寧, 巫嘉文. 不同方式治療前列腺良性增生療效與安全性對比. 現代儀器與醫療, 2016, 22(5): 112-114.
19. 張春鋒. 經尿道等離子切除術與經尿道鈥激光剜除術治療良性前列腺增生的療效分析. 中國保健營養, 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, 肇恒飛. 經尿道鈥激光剜除術與經尿道等離子切除術治療良性前列腺增生效果比較. 中國鄉村醫藥, 2017, 24(24): 40-41.
22. 袁寶國, 殷全忠. 經尿道前列腺等離子切除術與鈥激光剜除術治療良性前列腺增生對比研究. 實用老年醫學, 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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