***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study is to compare the efficacy and safety of diode laser enucleation of the prostate ( DiLEP ) with plasmakinetic enucleation of the prostate ( PKEP ) for symptomatic benign prostatic hyperplasia ( BPH ) patients with large prostate ( volume > 80 ml ) . From January 2013 to June 2014 , 80 consecutive patients were r and omized treated with DiLEP  ( n = 40 ) or PKEP ( n = 40 ) . Perioperative and postoperative outcome data were assessed during a 1-year follow-up . There were no significant preoperative differences between the two surgical groups . The mean prostate volumes in the DiLEP and PKEP groups were 98.6 and 93.3 ml , respectively . DiLEP was equivalent to PKEP in improvement in International Prostate Symptom Score ( IPSS ) , quality of life scores , and maximum flow rate . Compared with PKEP , patients treated with DiLEP showed a lower risk of blood loss ( P < 0.01 ) , shorter bladder irrigation and catheterization times ( P < 0.01 ) , as well as shorter hospital stays ( P < 0.01 ) . Moreover , the DiLEP group was significantly superior to bipolar plasmakinetic group in the irritative symptoms . However , the operation time of the DiLEP group was longer than that of PKEP group ( P = 0.02 ) . Both DiLEP and PKEP are safe and effective methods for the treatment of BPH in large prostates ( volume > 80 ml ) . Compared with PKEP , DiLEP provides a decreased risk of hemorrhage , reduced bladder irrigation , and catheterization times , as well as shorter hospital stays Purpose Bipolar endoscopic enucleation of the prostate ( BEEP ) was recommended by the 2016 EAU guidelines as the first choice of surgical treatment in men with a substantially enlarged prostate and moderate-to-severe lower urinary tract symptoms . The main aim of this study was to compare a modified diode laser enucleation of the prostate ( DiLEP ) to BEEP . Methods A total of 114 patients with prostate ( 20–160 mL ) were r and omized 1:1 into either DiLEP or BEEP in a dual-centre , non-inferiority- design r and omized-controlled trial . The primary outcomes included Qmax and IPSS at 12 months . Non-inferiority was evaluated by comparing the two-sided 95 % CI for the mean differences of Qmax and IPSS . Secondary endpoints included other perioperative parameters , postoperative micturition variables , and complication rate . Results A total of 111 patients ( 97 % ) had completed the intent-to-treat analysis , The results showed that DiLEP was comparable to BEEP regarding Qmax ( 28.0 ± 7.0 vs. 28.1 ± 7.2 mL/s ) and IPSS ( 3.0 ± 2.2 vs. 2.9 ± 2.6 ) at 12 months , the non-inferiority was met for both Qmax and IPSS . There were also no significant difference between two groups regarding tissue removal rate ( 71.8 vs. 73.8 % ) , hemoglobin decrease ( 0.33 ± 0.66 vs. 0.36 ± 0.75 g/dL ) , sodium decrease ( 1.0 ± 2.7 vs. 0.3 ± 2.9 mmol/L ) , and Clavien III complications ( 5.3 vs. 1.8 % ) at 12 months . Conclusions This DiLEP is an anatomical endoscopic enucleation technique for the treatment of benign prostatic hyperplasia , it is non-inferior to BEEP regarding Qmax and IPSS at 12 months postoperatively PURPOSE To compare the safety and efficacy of thulium laser enucleation of the prostate ( ThuLEP ) with plasmakinetic enucleation of the prostate ( PKEP ) . METHODS A total of 127 patients with benign prostatic hyperplasia ( BPH ) were r and omized to either ThuLEP ( n = 61 ) or PKEP ( n = 66 ) . All patients were assessed preoperatively and followed up at 3 , 6 , and 12 months postoperatively . Baseline characteristics of the patients , perioperative data , postoperative outcomes , and complications were recorded . RESULTS The decrease in hemoglobin level and the catheter time were statistically significantly lower in the ThuLEP group compared with the PKEP group ( 0.80 ± 0.49 vs 0.99 ± 0.52 , p = 0.037 , and 1.85 ± 0.94 vs 2.28 ± 1.34 , p = 0.042 ) . There were no statistical differences in complications between the two groups ( p > 0.05 ) . There was a significant improvement in 3 , 6 , and 12 months ' parameters compared with preoperative values ( p < 0.001 ) . Assessment at the 12-month follow-up showed no difference in urinary parameters between the two groups . CONCLUSIONS ThuLEP and PKEP are both safe and efficient procedures for the treatment of patients with BPH . Compared with PKEP , ThuLEP provided less risk of hemorrhage and shorter catheter time , although the differences may be of little clinical relevance . Further well- design ed trials with extended follow-up and larger sample size are needed to draw final conclusions about the efficacy of the two procedures OBJECTIVE To compare the clinical outcomes between thulium laser transurethral enucleation of the prostate ( ThuLEP ) and plasmakinetic bipolar resection of the prostate ( PKRP ) for treating benign prostatic hyperplasia ( BPH ) in a prospect i ve r and omized trial with 18 months of follow-up . METHODS The study r and omized 158 consecutive patients with BPH to ThuLEP ( n = 79 ) or PKRP ( n = 79 ) . All patients were evaluated preoperatively and at 1 , 3 , 6 , 12 , and 18 months after surgery by International Prostate Symptom Score ( IPSS ) , quality of life score ( QOLS ) , maximum flow rate ( Qmax ) , and postvoid residual urine volume ( PVR ) . RESULTS The 79 patients in each study arm each showed no significant difference in preoperative parameters . Compared with PKRP , ThuLEP required a longer operation time ( 65.4 vs 47.4 minutes , P = .022 ) but result ed in less hemoglobin decrease ( 0.15 vs 0.30 g/dL , P = .045 ) . ThuLEP also needed less catheterization time ( 2.1 vs 3.5 days , P = .031 ) , irrigation volume ( 12.4 vs 27.2 L , P = .022 ) , and hospital stay ( 2.5 vs 4.6 days , P = .026 ) . During the 1 , 3 , 6 , 12 , and 18 months of follow-up , the procedures did not demonstrate a significant difference in Qmax , IPSS , PVR , and QOLS . CONCLUSION ThuLEP and PKRP both relieve lower urinary tract symptoms equally , with high efficacy and safety . ThuLEP was statistically superior to PKRP in blood loss , catheterization time , irrigation volume , and hospital stay but inferior to PKRP in operation time . However , procedures did not differ significantly in Qmax , IPSS , PVR , and QOLS through the 18 months of follow-up Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more To evaluate the safety and efficacy of plasmakinetic enucleation of the prostate ( PKEP ) for the treatment of symptomatic benign prostatic hyperplasia ( BPH ) compared with 160-W lithium triboride laser photoselective vaporization of the prostate ( PVP ) . From February 2011 to July 2012 , a prospect i ve nonr and omized study was performed . One-hundred one patients underwent PKEP , and 110 underwent PVP .  No severe intraoperative complications were recorded , and none of the patients in either group required a blood transfusion . Shorter catheterization time ( 38.14 ± 23.64 h vs 72.54 ± 28.38 h , P < 0.001 ) and hospitalization ( 2.32 ± 1.25 days vs 4.07 ± 1.23 days , P < 0.001 ) were recorded in the PVP group . At 12-month postoperatively , the PKEP group had a maintained and statistically improvement in International Prostate Symptom Score ( IPSS ) ( 4.07 ± 2.07 vs 5.00 ± 2.10 ; P < 0.001 ) , quality of life ( QoL ) ( 1.08 ± 0.72 vs 1.35 ± 0.72 ; P= 0.007 ) , maximal urinary flow rate ( Qmax ) ( 24.75 ± 5.87 ml s−1 vs 22.03 ± 5.04 ml s−1 ; P < 0.001 ) , postvoid residual urine volume ( PVR ) ( 14.29 ± 6.97 ml vs 17.00 ± 6.11 ml ; P= 0.001 ) , and prostate-specific antigen ( PSA ) value ( 0.78 ± 0.57 ng ml−1 vs 1.27 ± 1.07 ng ml−1 ; P < 0.001 ) . Both PKEP and PVP relieve low urinary tract symptoms ( LUTS ) due to BPH with low complication rates . PKEP can completely remove prostatic adenoma while the total amount of tissue removed by PVP is less than that can be removed by PKEP . Based on our study of the follow-up , PKEP provides better postoperative outcomes than PVP PURPOSE Transurethral resection of the prostate has for decades been the st and ard surgical therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia , the most common benign neoplasm in men . To generate a contemporary reference for evolving medical and minimally invasive therapies we analyzed complications and immediate outcomes of transurethral prostate resection in a statewide multicenter study . MATERIAL S AND METHODS We prospect ively evaluated 10,654 patients undergoing transurethral prostate resection in the state of Bavaria , Germany from January 1 , 2002 until December 31 , 2003 . Case records containing 54 items concerning preoperative status , operation details , complications and immediate outcome , were recorded for each patient . RESULTS The mortality rate for transurethral prostate resection was 0.10 % . The cumulative short-term morbidity rate was 11.1 % . The most relevant complications were failure to void ( 5.8 % ) , surgical revision ( 5.6 % ) , significant urinary tract infection ( 3.6 % ) , bleeding requiring transfusions ( 2.9 % ) and transurethral resection syndrome ( 1.4 % ) . The resected tissue averaged 28.4 gm . Incidental carcinoma of the prostate was diagnosed by histological examination in 9.8 % of patients . Urinary peak flow rate increased significantly to 21.6 + /- 9.4 ml per second ( baseline 10.4 + /- 6.8 ml per second , 1 tail p < 0.0001 ) , while post-void residual decreased to 31.1 + /- 73.0 ml ( baseline 180.3 + /- 296.9 ml , 1-tail p < 0.0001 ) . CONCLUSIONS In a large scale evaluation comprising 44 mostly nonacademic urological departments in Bavaria , unique real-world data for transurethral prostate resection were prospect ively generated . This most contemporary information should be of use to potential patients and facilitate subsumption of emerging surgical and nonsurgical benign prostatic hyperplasia treatment options PURPOSE We compared plasmakinetic resection with holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia by analyzing 2-year followup data from a prospect i ve r and omized clinical trial . MATERIAL S AND METHODS A total of 280 patients were r and omly treated with plasmakinetic resection or holmium laser enucleation of the prostate .  Perioperative and postoperative outcome data were obtained during a 2-year followup . RESULTS No significant differences between the 2 surgical groups were observed in the preoperative data . Both groups displayed significant improvements after surgery . However , we identified no significant differences between the 2 groups in the 2-year followup data for I-PSS ( International Prostate Symptom Score ) , quality of life scores or maximum flow rate values . Patients in the holmium laser enucleation group displayed a lower risk of hemorrhage , shorter bladder irrigation and catheter times , and shorter hospital stays . A larger amount of prostate tissue was retrieved in the holmium laser enucleation group , but the operation time was longer for this group than for the plasmakinetic 
    Output:
    
Furthermore , there were no significant differences between lasers and bipolar technology in the maximum flow rate ( Qmax ) and international prostate symptom score ( IPSS ) at a minimum of 3 months after treatment .
Complications , including urethral stricture , urinary incontinence , urinary tract infection , re-catheterization and blood transfusion , did not significantly differ between lasers and bipolar technology .
Conclusion Early efficacy and safety profiles were comparable between bipolar and laser treatments .
Differences were observed in terms of smaller reduction in Hb , shorter catheterization duration and shorter hospital stay in favor of lasers .
However , the smaller reduction in Hb , with lasers , did not translate into reduced transfusion requirements .