MUHAMMAD ZANIAR RAMADHANI, - (2022) Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) using Moses Technology and Standard HoLEP: A Systematic Review and Meta-Analysis. Skripsi thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Holmium Laser Enucleation of the Prostate (HoLEP) is one of the minimally invasive procedures which is used in the management of BPH. Several uses of HoLEP are not optimal due to the learning curve in HoLEP, requiring a longer time, which causes total operative time was longer, more bleeding, and higher complications in the early use. With the increase of technological advancement in medicine, the steep learning curve could be solved with the invention of Moses HoLEP. This study aimed to evaluate the comparison of efficacy between Moses HoLEP and standard HoLEP in BPH patients. A systematic search was performed in several databases, consisting of PubMed, Scopus, and Embase. Randomized Controlled Trial (RCT) and comparative observational studies were searched. Prisma guideline was implemented in the search strategy. Risk of bias assessment was performed using Cochrane Risk of Bias Tools 2 for RCT and Newcastle Ottawa Scale for the retrospective studies. A total of 7 studies consisting of two RCTs and 5 retrospective studies were included. A quantitative analysis was performed in the outcome of total operative time, enucleation time, hemostasis time, laser usage time, and change in hemoglobin. From the result of analysis, there was significant difference which Moses HoLEP possessed faster total operative time (MD: -12.09, 95% CI: -18.67 – -5.51, p = 0.0003), faster enucleation time (MD: -3.00, 95% CI: - 5.57 – -0.43, p = 0.02), faster hemostasis time (MD: -3.79, 95% CI: -5.23 – -2.34, p < 0.00001), and faster laser usage time (MD: -2.79, 95% CI: -5.03 – -0.55, p = 0.01). However, there was no significant difference found in the outcome of change in hemoglobin (MD: -0.25, 95% CI: -0.57 – 0.06, p = 0.12). Keywords: Moses HoLEP, Holmium Enucleation of the Prostate, Benign Prostatic Hyperplasia.

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