Comprehensive efficacy of different prostate resection volumes for patients with benign prostatic hyperplasia: a systematic review and meta-analysis

Benign prostatic hyperplasia is one of the most common urological diseases in middle-aged and elderly men worldwide. The most effective treatment is surgery, and multiple surgical approaches, including traditional electroprostatectomy, laser vaporization, or steam ablation, have already been widely applied in clinical practice. However, few studies summarizing and reporting the comprehensive outcomes of whether different prostate resection volumes affect the efficacy of benign prostatic hyperplasia surgery exist. Thus, we conducted a systematic review and meta-analysis involving cohort studies and randomized controlled trials to compare the postoperative influence of different residual prostate volumes in patients with benign prostatic hyperplasia (BPH) to explore the best surgical treatment and minimize the recurrence rate and other complications. A total of 16 randomized controlled trials (RCTs) involving 2,164 patients who underwent prostate surgery were included in our analysis. In summary, compared with patients who had a smaller resected prostate volume, patients with more resected prostate tissue were more likely to have a lower International Prostate Symptom Score (IPSS), a lower postvoid residual urine volume (PVR), a higher quality of life (QoL) and maximal urinary flow rate (Qmax), and a decreased risk of bladder neck construction. However, patients with less resected prostate volume had advantages in terms of decreasing catheterization time, hospital stay, irrigation time, and the rates of blood transfusion and retrograde ejaculation. Moreover, the resected prostate volume was not correlated with the incidence of other complications. Given the limitations existing in our study, more primary studies are still needed in the future.