Table 4. Summary of postoperative outcomes.
| Outcome | No. of studies | Trial size EP/OP | WMD(95% CI) | P value | Heterogeneity | Favors | |
|---|---|---|---|---|---|---|---|
| I2 | P value | ||||||
| IPSS 3 mo HoLEP vs OP | 6, 21, 35 | 133/127 | 0.29 [-0.36, 0.93] | 0.38 | 30% | 0.24 | None |
| IPSS 3 mo BEEP vs OP | 22, 23, 25 | 160/155 | 0.15 [-0.45, 0.75] | 0.63 | 0% | 0.84 | None |
| IPSS 3 mo total | 6, 21–23, 25, 35 | 293/282 | 0.21 [-0.23, 0.65] | 0.34 | 0% | 0.65 | None |
| IPSS 6 mo HoLEP vs OP | 35 | 60/60 | -0.40 [-1.50, 0.70] | 0.48 | / | / | None |
| IPSS 6 mo BEEP vs OP | 22, 24, 25 | 191/189 | 0.04 [-0.52, 0.59] | 0.90 | 0% | 0.95 | None |
| IPSS 6 mo total | 22, 24, 25, 35 | 251/249 | -0.05 [-0.55, 0.44] | 0.83 | 0% | 0.90 | None |
| IPSS 12 mo HoLEP vs OP | 6, 35 | 101/99 | 0.00 [-0.64, 0.65] | 0.99 | 0% | 0.97 | None |
| IPSS 12 mo BEEP vs OP | 22–25 | 237/233 | -0.15 [-0.50, 0.21] | 0.42 | 0% | 0.98 | None |
| IPSS 12 mo total | 6, 22–25, 35 | 338/332 | -0.11 [-0.42, 0.20] | 0.48 | 0% | 1.00 | None |
| Qmax 3 mo HoLEP vs OP | 6, 21, 35 | 133/127 | -0.35 [-2.51, 1.81]* | 0.79 | 21% | 0.28 | None |
| Qmax 3 mo BEEP vs OP | 22, 23, 25 | 160/155 | -0.70 [-3.08, 1.68]* | 0.56 | 77% | 0.01 | None |
| Qmax (mL/s) 3 mo total | 6, 21–23, 25, 35 | 293/282 | -0.65 [-2.28, 0.98]* | 0.44 | 64% | 0.02 | None |
| Qmax 6 mo HoLEP vs OP | 35 | 60/60 | 2.90 [0.67, 5.13] | 0.01 | / | / | HoLEP |
| Qmax 6 mo BEEP vs OP | 22, 24, 25 | 191/189 | 0.45 [-0.89, 1.78] | 0.51 | 0% | 0.92 | None |
| Qmax 6 mo total | 22, 24, 25, 35 | 251/249 | 1.09 [-0.05, 2.24] | 0.06 | 17% | 0.31 | None |
| Qmax 12 mo HoLEP vs OP | 6, 35 | 101/99 | -1.53 [-3.40, 0.34] | 0.11 | 0% | 0.62 | None |
| Qmax 12 mo BEEP vs OP | 22–25 | 237/233 | -0.31 [-1.40, 0.78] | 0.58 | 0% | 0.47 | None |
| Qmax 12 mo total | 6, 22–25, 35 | 338/332 | -0.62 [-1.56, 0.32] | 0.20 | 0% | 0.55 | None |
| QoL 3 mo HoLEP vs OP | 6,21 | 73/67 | 0.24 [-0.06, 0.53]* | 0.11 | 71% | 0.06 | None |
| QoL 3 mo BEEP vs OP | 22, 23, 25 | 160/155 | -0.15 [-0.37, 0.07]* | 0.19 | 0% | 0.75 | None |
| QoL3 mo total | 6, 21–23, 25 | 233/222 | 0.05 [-0.18, 0.27]* | 0.69 | 63% | 0.03 | None |
| QoL 6 mo HoLEP vs OP | / | / | / | / | / | / | / |
| QoL 6 mo BEEP vs OP | 22, 24, 25 | 191/189 | -0.07 [-0.32, 0.19] | 0.60 | 0% | 0.94 | None |
| QoL 6 mo total | 22, 24, 25 | 191/189 | -0.07 [-0.32, 0.19] | 0.60 | 0% | 0.94 | None |
| QoL 12 mo HoLEP vs OP | 6 | 41/39 | -0.07[-0.46, 0.32] | 0.72 | / | / | None |
| QoL 12 mo BEEP vs OP | 22–25 | 240/233 | -0.08 [-0.25, 0.09] | 0.38 | 0% | 0.74 | None |
| QoL 12 mo total | 6, 22–25 | 281/272 | -0.08 [-0.23, 0.08] | 0.35 | 0% | 0.87 | None |
| PVR 3 mo HoLEP vs OP | 21, 35 | 92/88 | -0.75 [-10.93, 9.43]* | 0.88 | 83% | 0.02 | None |
| PVR 3 mo BEEP vs OP | 22, 23, 25 | 160/155 | -0.46 [-2.27, 1.35]* | 0.62 | 0% | 0.89 | None |
| PVR (mL) 3 mo total | 21–23, 25, 35 | 252/243 | -0.47 [-3.32, 2.38]* | 0.75 | 35% | 0.19 | None |
| PVR 6 mo HoLEP vs OP | 35 | 60/60 | 2.30 [-0.87, 5.47] | 0.16 | / | / | None |
| PVR 6 mo BEEP vs OP | 22, 24, 25 | 191/189 | -0.29 [-1.64, 1.07] | 0.68 | 0% | 0.99 | None |
| PVR 6 mo total | 22, 24, 25, 35 | 251/249 | 0.11 [-1.13, 1.36] | 0.86 | 0% | 0.54 | None |
| PVR 12 mo HoLEP vs OP | 35 | 60/60 | -0.60 [-5.85, 4.65] | 0.82 | / | / | None |
| PVR 12 mo BEEP vs OP | 22–25 | 237/233 | -0.20 [-1.39, 0.99] | 0.74 | 0% | 0.61 | None |
| PVR 12 mo total | 22–25, 35 | 297/293 | -0.22 [-1.38, 0.94] | 0.71 | 0% | 0.76 | None |
| IIEF-5 3 mo EP vs OP | 6, 22 | 84/79 | 0.47 [-0.64, 1.59] | 0.41 | 0% | 0.68 | None |
| IIEF-5 6 mo EP vs OP | 6, 22, 24 | 162/158 | -0.44[-2.03, 1.14]* | 0.58 | 61% | 0.08 | None |
| IIEF-5 12 mo EP vs OP | 6, 22, 24 | 161/157 | 1.00[0.21, 1.78] | 0.01 | 9% | 0.33 | EP |
| IIEF-5 24 mo EP vs OP | 6, 24 | 121/119 | 0.89 [-0.01, 1.80] | 0.05 | 0% | 0.62 | None |
*Using a random effect model;
EP = endoscopic enucleation of the prostate; OP = open prostatectomy; WMD = weighted mean difference; HoLEP = holmium laser enucleation of the prostate; BEEP = bipolar electrosurgical enucleation of the prostate; IPSS = International Prostate Symptom Score; Qmax = maximum flow rate; QoL = quality of life; PVR = post-void residual urine volume; IIEF-5 = International Index of Erectile Function; mo = month.