Meta-analysis shows shorter operative time and hospital stay with ThuLEP versus RASP for large-volume BPH

This systematic review and meta-analysis compared Robot-assisted simple prostatectomy (RASP) and laser enucleation of the prostate (LEP) for patients with large-volume benign prostatic hyperplasia (BPH, ≥80 mL). The pooled analysis included 2,231 patients, comprising 763 receiving RASP and 1,468 receiving LEP. The primary outcome was not reported, but secondary outcomes included operative time, catheterization duration, and hospital stay.

Results indicated that LEP was associated with shorter operative time than RASP. Similarly, LEP was associated with shorter catheterization duration than RASP. For hospital stay, thulium fiber laser enucleation of the prostate (ThuLEP) showed a reduction with a mean difference of 2.43 days, with a 95% confidence interval of 1.52–3.34 and a p-value less than 0.05.

The authors did not report adverse events, serious adverse events, discontinuations, or tolerability data. No specific limitations were listed in the source text. The evidence suggests procedural efficiency benefits for LEP in this specific population, though long-term safety and functional outcomes remain unaddressed in this synthesis.