Objective  To systematically evaluate the efficacy and safety of transurethral plasmakinetic prostatectomy (TUPKP) and trans urethral resection of prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). 

Methods  We searched the databases of PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Weipu, China Biomedical Literature Database and Wanfang Database, and collected relevant randomized controlled trials (RCTs) from their inception to September 15, 2020. Data extraction and assessment of risk of bias were performed by two reviewers independently. Meta-analysis was performed using Stata 16.0 software. 

Results  A total of 45 RCTs involving 6 490 subjects were included. The results of Meta-analysis showed that, in patients with normal volume of prostate (<80 mL) BPH, in terms of effectiveness, results for TUPKP were superior to TURP for the postoperative 3 months international prostate symptom score, 60 months maximum flow rate (maximum flow rate, Qmax) score, 6 months international erectile function score and 60 months residual urine volume. However, there were no statistical difference in the quality of life score and the weight of the resected tissue in the third to sixty months after surgery; In terms of safety, TUPKP was superior to TURP in terms of the time of operation, hospitalization, bladder irrigation, postoperative catheterization, decreased the intraoperative blood loss, and the incidence of postoperative urethral stricture, and the difference were statistically significant. In the terms of effectiveness for patients with large volume (≥80 mL) BPH, Qmax and resection tissue weight at 3 and 12 months after TUPKP were not statistically different from those in the TURP group. In the terms of safety, TUPKP was superior than TURP in operating time, length of hospitalization and intraoperative blood loss, and the differences were statistically significant. 

Conclusion  The current evidence shows that TUPKP is equivalent to TURP in treatment efficacy, but is superior to TURP in terms of safety for patients with normal or large BPH.

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