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Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lase...

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Autores principales: Zhang, Xingming, Shen, Pengfei, He, Qiying, Yin, Xiaoxue, Chen, Zhibin, Gui, Haojun, Shu, Kunpeng, Tang, Qidun, Yang, Yaojing, Pan, Xiuyi, Wang, Jia, Chen, Ni, Zeng, Hao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4806333/
https://www.ncbi.nlm.nih.gov/pubmed/27009501
http://dx.doi.org/10.1038/srep23503
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author Zhang, Xingming
Shen, Pengfei
He, Qiying
Yin, Xiaoxue
Chen, Zhibin
Gui, Haojun
Shu, Kunpeng
Tang, Qidun
Yang, Yaojing
Pan, Xiuyi
Wang, Jia
Chen, Ni
Zeng, Hao
author_facet Zhang, Xingming
Shen, Pengfei
He, Qiying
Yin, Xiaoxue
Chen, Zhibin
Gui, Haojun
Shu, Kunpeng
Tang, Qidun
Yang, Yaojing
Pan, Xiuyi
Wang, Jia
Chen, Ni
Zeng, Hao
author_sort Zhang, Xingming
collection PubMed
description All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.
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spelling pubmed-48063332016-03-25 Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis Zhang, Xingming Shen, Pengfei He, Qiying Yin, Xiaoxue Chen, Zhibin Gui, Haojun Shu, Kunpeng Tang, Qidun Yang, Yaojing Pan, Xiuyi Wang, Jia Chen, Ni Zeng, Hao Sci Rep Article All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. Nature Publishing Group 2016-03-24 /pmc/articles/PMC4806333/ /pubmed/27009501 http://dx.doi.org/10.1038/srep23503 Text en Copyright © 2016, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Zhang, Xingming
Shen, Pengfei
He, Qiying
Yin, Xiaoxue
Chen, Zhibin
Gui, Haojun
Shu, Kunpeng
Tang, Qidun
Yang, Yaojing
Pan, Xiuyi
Wang, Jia
Chen, Ni
Zeng, Hao
Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title_full Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title_fullStr Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title_full_unstemmed Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title_short Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
title_sort different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4806333/
https://www.ncbi.nlm.nih.gov/pubmed/27009501
http://dx.doi.org/10.1038/srep23503
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