This study compared the efficacy and safety of En-Bloc and standard techniques in laser enucleation, providing an evidence-based basis for surgical decision-making in the management of benign prostatic obstruction (BPO).
Relevant studies were systematically identified through searches of PubMed, Embase, Web of Science, and Cochrane Library databases up to May 2025. Data analysis was performed using RevMan 5.4.
Data from 15 studies containing 9,397 participants were reviewed. The En-Bloc technique was associated with a reduction in enucleation time (mean difference [MD] - 8.43, 95% CI -13.0 to -3.91, p < 0.001), an increase in enucleation efficiency (MD 0.21, 95% CI 0.07 to 0.36, p = 0.004), a decrease in operative time (MD -4.70, 95% CI -8.81 to -0.60, p = 0.02), and a lower rate of major complications (odds ratio 0.62, 95% CI 0.42-0.90, p = 0.01) than the standard technique. No significant differences in postoperative short-term functional outcomes were found.
The updated evidence suggests that the En-Bloc technique is associated with improved perioperative performance and a lower rate of major complications compared to the conventional approach, while preserving comparable functional outcomes. These findings suggest potential clinical benefits of En-Bloc enucleation in the surgical management of BPO.
Journal of investigative surgery : the official journal of the Academy of Surgical Research. 2026 Jun 09 [Epub]
Jinze Li, Jing Liu, Puze Wang, Peihai Zhang, Dong Lv
Department of Urology, People's Hospital of Deyang City, Chengdu University of Traditional Chinese Medicine, Deyang, China., Department of Urology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China., Institute of Andrology, Chengdu University of Traditional Chinese Medicine, Chengdu, China.