Evidence map›Paper›PMID 40348823›Full record

SynthesisProstate cancer and prostatic diseases2025

Endoscopic enucleation of the prostate versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review and meta-analysis.

Lequang T Vo, David Armany, Venu Chalasani, Simon V Bariol, Sriskanthan Baskaranathan, Tania Hossack, David Ende, Henry H Woo

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Best of 2025 in prostate cancer and prostatic diseases.Prostate cancer and prostatic diseases · 2026
    Article
  6. Review
  7. Review
  8. Observational
  9. Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lequang T Vo *Department of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.ORCID 0009-0001-8745-6638
David Armany *Department of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.
Venu ChalasaniSchool of Medicine, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-1356-9610
Simon V BariolDepartment of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.
Sriskanthan BaskaranathanDepartment of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.
Tania HossackDepartment of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.
David EndeDepartment of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia.
Henry H WooDepartment of Urology, Blacktown Mount-Druitt Hospital, Sydney, NSW, Australia. henry.woo@health.nsw.gov.au.ORCID 0000-0003-4099-0339

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic enucleation of the prostate (EEP) has emerged as a leading surgical treatment for benign prostatic hyperplasia (BPH), traditionally managed by transurethral resection of the prostate (TURP). EEP involves complete adenoma removal along the surgical capsule and can be performed using different energy sources, such as holmium, thulium, GreenLight and diode lasers, or bipolar electrocautery. This meta-analysis compares the efficacy and safety of EEP versus TURP.

methodsA comprehensive search of MEDLINE, EMBASE, CENTRAL, Web of Science, and Scopus (2003-present) identified randomised controlled trials (RCTs) comparing EEP with TURP in adult males (≥18 years) with BPH. Primary outcomes comprised functional measures (Qmax, PVR, IPSS, QoL, IIEF-5), while secondary outcomes included adverse events (incontinence, bleeding, infection, re-treatment rates, hospital stay duration). Two reviewers independently performed data extraction and assessed risk of bias using the Cochrane RoB2 tool.

resultsTwenty-eight RCTs (n = 3085) met inclusion criteria: 1538 patients underwent EEP and 1547 underwent TURP. EEP was associated with significantly improved IPSS (at 12 months), Qmax (1, 6, 12, 24 months), and PVR (6, 12, 36 months) compared with TURP. Perioperative outcomes favoured EEP, including shorter catheterisation time (MD = -1.12 days), reduced hospital stay (MD = -0.92 days), and lower transfusion rates (RR = 0.22). No significant differences were observed in long-term incontinence or bladder neck contracture, though EEP yielded lower stricture rates (RR = 0.55) and reoperation rates for recurrent BPH (RR = 0.32). Heterogeneity was high in several outcomes, reflecting variability in patient characteristics, enucleation techniques, and surgeon experience.

conclusionsEEP compares favourably with TURP for BPH, providing notable benefits in bleeding control, faster recovery and durable obstruction relief. Anatomical enucleation yields functional outcomes at least equal and often superior to TURP. Energy source choice may reflect resources and surgeon preferences. Future research should distinguish enucleation completeness from energy source.

Indexed as

EndoscopyProstateProstatic HyperplasiaTransurethral Resection of ProstateHumansMalePostoperative ComplicationsRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID40348823
PMCPMC12643921

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.