Comparing GreenLight PVP and HoLEP beyond 5 years: A systematic review of long‐term functional outcomes and reoperation rates
Bibliographic record
Abstract
Objectives: This study aimed to compare long-term (≥ 5 years) functional outcomes and reoperation rates following holmium laser enucleation of prostate (HoLEP) vs GreenLight photoselective vaporisation of prostate (GLPVP). Methods: MEDLINE, Embase and Cochrane databases were searched from inception to December 2023. Included were randomised controlled trials (RCTs), cohort studies and case series studying HoLEP and/or GLPVP, where functional outcomes and reoperation rates were reported. Studies with <5-year follow-up were excluded. Evidence was synthesised as a comparison across all parameters. Quality of evidence was assessed with the Newcastle-Ottawa Scale. Results: Of 3047 records identified, 25 were eligible, including two RCTs, two cohort studies, one cross-sectional study and 20 case series. Twenty-three studies focused on HoLEP or GLPVP, whilst two were comparative studies. HoLEP demonstrated long-term durability of outcomes and low reoperation rates (mean 4.1%, range 2.0%-6.3%) at a mean follow-up of 7.3 years. GLPVP also had durable outcomes at 5-year follow-up, but inconclusive evidence for improvements at 10 years. Reoperation rates were also higher (mean 12.6%, range 3.8%-33.3%). This is in keeping with findings of comparative studies, where HoLEP demonstrated greater improvements in all functional parameters except PVR, and lower reoperation rates. Findings are limited by patient attrition, lack of comparative studies and long-term data beyond 10 years. Three studies examined the 180-W GLPVP model at 5 years showed superior durability to earlier 80-W/120-W models. Conclusions: Current evidence suggests that HoLEP provides significantly greater functional improvements and a lower reoperation rate when compared with the GLPVP 80-W/120-W model at 5-year follow-up. The 180-W model is comparable with HoLEP based on limited data at 5 years, but there is a lack of data beyond 10 years for longer-term functional outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".