MATERIALS AND METHODS: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the study protocol was registered with Prospero (CRD42024509627). Searches were conducted in Medline, Embase, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature up to February 1, 2024, to include studies that compare HoLEP and RASP in patients with BPH. Risk of bias was evaluated using the Newcastle Ottawa Scale.
RESULTS: HoLEP and RASP demonstrated equivalent effectiveness in treating BPH, as shown by similar functional outcomes such as maximum urinary flow rate and postvoid residual volume. However, HoLEP outperformed RASP in several operational efficiency metrics, reducing operative time by 49.48 minutes, hospitalization duration by 1.5 days, and catheterization period by 3.8 days. HoLEP also significantly reduced the risk of blood transfusions by 75%. Patients undergoing RASP were 1.87 times more at risk for grade 2 complications and 3.41 times more at risk for developing grade 3 or above complications.
CONCLUSIONS: HoLEP and RASP are effective for managing BPH. HoLEP shows advantages in recovery metrics and lower blood transfusion rates, while RASP benefits from ease of implementation in robotic-equipped facilities. Optimizing surgical outcomes will depend on reducing disparities in technique adoption, improving surgical training, and aligning with evidence-based guidelines.
MATERIALS AND METHODS: The addressed focused question was "Is SLT effective in the management of OPL?" Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1970 up to and including February 2017.
RESULTS: Ten studies were included. The reported number of OPL ranged between 8 and 140. Oral pigmented sites included, gingiva, buccal and labial mucosa, alveolar mucosa and lips. Lasers used in the studies included Q-switched alexandrite, Neodymium-doped yttrium aluminium garnet, diode, Erbium: yttrium aluminium garnet and carbon dioxide laser. Laser wavelength, power output and number of irradiations were 635-10,600nm, 1-10W and 1 to 9 times, respectively. The follow up period ranged from 6 to 24months. All studies reported SLT to be effective in the treatment of OPL. In five studies, recurrence of OPL occurred which ranged from 21.4% to 45%.
CONCLUSIONS: Lasers are effective in the management of OPL including physiologic gingival pigmentation, smokers' melanosis and pigmentation in Laugier-Hunziker syndrome. Different laser types (CO2, Er:YAG and Diode) showed comparable outcomes in the treatment of OPL.
MATERIALS AND METHODS: Retrospective analysis was conducted on patients undergoing SSB-RIRS from January 2015 to June 2022 across 21 centers worldwide. Three months perioperative and postoperative outcomes were recorded, focusing on complications and stone-free rates (SFR).
RESULTS: A total of 733 patients were included, with 415 in group 1 (Ho:YAG) and 318 in group 2 (TFL). Both groups have similar demographic and stone characteristics. Group 1 had more incidence of symptomatic pain or hematuria (26.5% vs. 10.4%). Operation and lasing times were comparable. The use of baskets was higher in group 1 (47.2% vs. 18.9%, p<0.001). Postoperative complications and length of hospital stay were similar. Group 2 had a higher overall SFR. Multivariate regression analysis indicated that age, presence of stone at the lower pole, and stone diameter were associated with lower odds of being stone-free bilaterally, while TFL was associated with higher odds.
CONCLUSIONS: Our study shows that urologists use both lasers equally for SSB-RIRS. Reintervention rates are low, safety profiles are comparable, and single-stage bilateral SFR may be better in certain cases. Bilateral lower pole and large-volume stones have higher chances of residual fragments.
METHOD: In a retrospective analysis, 237 patients diagnosed with high-risk benign prostatic hyperplasia (BPH) underwent prostate enucleation using three different groups of surgical instruments at the Department of Urology, the First Affiliated Hospital of Jinzhou Medical University. These groups included the red laser device group (n = 67), the green laser device group (n = 61), and the plasma device group (n = 109). The study evaluated changes in prostate mass, blood loss, operation time, and postoperative efficacy at 1- and 6-month intervals, as well as any associated complications.
RESULTS: The red and green laser surgical instrument groups demonstrated superiority over the plasma group in several aspects. (1) Operation Time: *1* Red laser group: 87.9 ± 14.7 minutes; *1* Green laser group: 86.1 ± 15.3 minutes. (2) Blood Loss: *1* Red laser group: 30.1 ± 5.9 mL; *2*Green laser group: 30.9 ± 6.1 mL. (3) Temporary Urinary Incontinence: *1*Red laser group: 3 cases (4.48%); *2*Green laser group: 2 cases (3.28%). These differences were statistically significant. Additionally, postoperative indicators such as IPSS(International Prostate Prostate Symptom Score), QoL(Quality of Life), Q max(The Maximum Flow Rate), and RUV(Residual Urine Volume) showed significant improvement in all three groups compared to the preoperative state.
CONCLUSION: Red laser, green laser and plasma surgical devices were safe and effective in the treatment of high critical benign prostatic hyperplasia; laser surgical devices showed better performance in terms of operation time, intraoperative bleeding and complications.
METHODS: A prospective cohort of patients who underwent LD was compared with a retrospective control that underwent BD. In both groups, early apical release was performed, and the adenoma was split at 12 O'clock after complete enucleation. In LD, a trans-capsular plane was sharply created by LD and is guided by the circular capsular fibers. A mechanical push with the resectoscope tip was used to create and maintain the ideal surgical plane in the BD group while the laser energy was used to achieve timely hemostasis. The primary outcome was stress urinary incontinence (SUI), defined as the need to use any number of pads, immediately after catheter removal, at 1 week and 1 month postoperatively.
RESULTS: Consecutive 51 (48.6%) and 54 (51.4%) patients underwent BD and LD, respectively. The LD group tends to be older while other demographics were comparable. Both groups were comparable regarding the estimated prostate volume, enucleation time, and postoperative resolution of symptoms. Continence recovery was in favor of the LD group immediately after removing the catheter (77.8% vs. 43.1%; p
METHODS: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines.
RESULTS: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Recipient twins were more likely to be affected by small bowel atresia (7 recipient and 4 donor cases) and NEC (3 recipient and 2 donor twins). Prenatal ultrasonographic abnormalities were demonstrated in 7 out of 9 cases with bowel atresia and in both cases of bowel perforation. The overall survival rate for neonates with bowel complications after FLA is 72%, but is much lower for co-twins at 22%. The survival rates for jejunoileal atresia and NEC are 91 and 40%, respectively.
CONCLUSIONS: It is uncertain as to whether these bowel anomalies are due to bowel ischaemia associated with TTTS, the treatment with FLA, or a combination of both. Cases with prenatal abdominal ultrasonographic abnormalities after FLA should have close prenatal and postnatal assessment to detect bowel complications.
METHODS: Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1980 up to and including July 2016. The addressed PICO question was: "What effect does aPDT and/or LT as an adjunct to SRP have on the GCF inflammatory proteins in periodontal disease patients?"
RESULTS: Eight studies used aPDT while 10 studies used laser alone. Eight cytokines including tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10, interferon gamma (IFN-γ), matrix metalloproteinase (MMP)-8 and granulocyte colony-stimulating factor (GM-CSF) were eligible for qualitative analysis for aPDT and LT studies. Four aPDT studies showed significant reduction in IL-1β while one study showed significant reduction in TNF-α levels after aPDT application at follow-up. One study showed significant reduction of IFN-γ, IL-8 and GM-CSF levels after aPDT at follow-up. IL-1β significantly reduced in 4 LT studies, while one study showed significant decrease for IL-6 and TIMP-1 levels. MMP-8 and TNF-α showed significant reduction in three and one study respectively.
CONCLUSION: It remains debatable whether adjunctive aPDT or LT is effective in the reduction of GCF inflammatory proteins in periodontal disease due to non-standard laser parameters and short follow up period. These findings should be considered preliminary and further studies with long-term follow up and standardized laser parameters are recommended.