Efficacy and safety of thulium fiber laser versus conventional holmium:YAG laser in anatomical endoscopic enucleation of the prostate: a systematic review and pairwise meta-analysis.
Oscar Emilio Valdez-Gil, Elvira Espinoza-Gonzalez, Laura Alejandra Zoller-Coronado et al.
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In 30 seconds
This systematic review and meta-analysis compared the efficacy and safety of thulium fiber laser enucleation (ThuFLEP) versus conventional holmium:YAG laser enucleation (HoLEP) in 3,509 adult men with benign prostatic obstruction. The study found a small significant reduction in the International Prostate Symptom Score (IPSS) at 3 months (MD -1.04 points), but overall, both techniques were clinically comparable.
Key findings
- ThuFLEP showed a mean reduction in IPSS of -1.04 points at 3 months.
- Qmax differences were small and inconsistent across follow-up periods.
- Stress urinary incontinence occurred less frequently with ThuFLEP (RR 0.75).
- Urge urinary incontinence was also less frequent with ThuFLEP (RR 0.39).
Why it matters
Understanding the comparative effectiveness of ThuFLEP and HoLEP is crucial for clinicians to make informed decisions regarding treatment options for benign prostatic obstruction, considering patient outcomes and safety.
What to keep in mind
The analysis faced limitations including few studies per outcome, heterogeneity, and mostly low/very low certainty evidence.