Objective  To evaluate the efficacy and safety of transurethral plasmakinetic prostatectomy (TUPKP) versus transurethral plasmakinetic enucleation of prostate (TUPEP) in treating benign prostate hyperplasia (BPH). 

Methods  PubMed, EMBASE, the Cochrane Library, CNKI, VIP, CBM database and Wanfang database were searched for relevant randomized controlled trials from January 1st, 2018until September 15, 2021, and references were manually searched. Two researchers independently conducted literature screening, data extraction and quality evaluation. Stata13.0 software was used for Meta-analysis. 

Results  A total of 30 studies were included, reporting on 3,218 BPH patients, of whom 1,626 received TUPKP and 1,592 received TUPEP. Meta-analysis of results show that: for effectiveness, when treating a normal volume (<80 mL) prostate, compared with the TUPEP group, the TUPKP group had less tissue removed, higher PVR at 6 and 12 months after surgery, but lower IIEF-5 at 3 and 6 months after surgery (P<0.05). When treating a large volume (≥80 mL) prostate, compared with the TUPEP group, the TUPKP group had less tissue removed, higher IPSS at 6 months after surgery, and smaller Qmax and higher PVR at 3 months after surgery (P<0.05). In terms of safety: when treating a normal volume prostate, compared with the TUPEP group, the TUPKP group had longer operation time, hospitalization time, catheterization time, bladder irrigation time, more bleeding during the operation, and higher risk of capsular perforation and bladder spasm (P<0.05). When treating a large volume prostate, compared with the TUPEP group, the TUPKP group had longer operation time, hospitalization time, catheterization time, and bladder irrigation time (P<0.05). 

Conclusion  For both normal or large volume prostates, the overall efficacy of TUPKP and TUPEP in the treatment of BPH is similar, but TUPEP is superior to TUPKP in terms of safety. 

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