***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: BACKGROUND The comparative outcome with GreenLight ( GL ) photoselective vaporisation of the prostate and transurethral resection of the prostate ( TURP ) in men with lower urinary tract symptoms due to benign prostatic obstruction ( BPO ) has been question ed . OBJECTIVE The primary objective of the GOLIATH study was to evaluate the noninferiority of 180-W GL XPS ( XPS ) to TURP for International Prostate Symptom Score ( IPSS ) and maximum flow rate ( Qmax ) at 6 mo and the proportion of patients who were complication free . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve r and omised controlled trial at 29 centres in 9 European countries involving 281 patients with BPO . INTERVENTION 180-W GL XPS system or TURP . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Measurements used were IPSS , Qmax , prostate volume ( PV ) , postvoid residual ( PVR ) and complications , perioperative parameters , and reintervention rates . Noninferiority was evaluated using one-sided tests at the 2.5 % level of significance . The statistical significance of other comparisons was assessed at the ( two-sided ) 5 % level . RESULTS AND LIMITATIONS The study demonstrated the noninferiority of XPS to TURP for IPSS , Qmax , and complication-free proportion . PV and PVR were comparable between groups . Time until stable health status , length of catheterisation , and length of hospital stay were superior with XPS ( p<0.001 ) . Early reintervention rate within 30 d was three times higher after TURP ( p=0.025 ) ; however , the overall postoperative reintervention rates were not significantly different between treatment arms . A limitation was the short follow-up . CONCLUSIONS XPS was shown to be noninferior ( comparable ) to TURP in terms of IPSS , Qmax , and proportion of patients free of complications . XPS results in a lower rate of early re interventions but has a similar rate after 6 mo . TRIAL REGISTRATION Clinical Trials.gov , identifier NCT01218672 PURPOSE To our knowledge we report the first single center , prospect i ve , r and omized study comparing holmium laser enucleation and high performance GreenLight ™ prostate photoselective vaporization as surgical treatment of prostatic adenomas greater than 60 ml . MATERIAL S AND METHODS A total of 80 patients with a large prostatic adenoma were r and omly assigned to surgical treatment with holmium laser enucleation or photoselective vaporization .  International Prostate Symptom Score , International Index of Erectile Function-15 , maximum flow rate , post-void residual urine , serum prostate specific antigen and transrectal ultrasound volume were recorded . RESULTS Patient baseline characteristics were similar for holmium laser enucleation and photoselective vaporization .  Operative time and catheter removal time were almost equal in the 2 groups ( p = 0.7 and 0.2 , respectively ) . Eight vaporization cases were converted to transurethral prostate resection or holmium laser enucleation intraoperatively due to bleeding . A significantly higher maximum flow rate and lower post-void residual urine were noted in holmium laser cases during the entire followup ( at 1 year each p = 0.02 ) . However , no significant difference in International Prostate Symptom Score , quality of life or International Index of Erectile Function-15 was detected . Prostate volume and serum PSA decreased 78 % and 88 % in the holmium laser group , and 52 % and 60 % in the vaporization group , respectively . CONCLUSIONS Holmium laser enucleation and photoselective vaporization are effective for lower urinary tract symptoms due to a large prostatic adenoma . Early subjective functional results ( maximum flow rate and post-void residual urine ) of holmium laser enucleation appear to be superior to those of photoselective vaporization . In our h and s cases intended to be treated with photoselective vaporization were at 22 % risk of conversion to another modality . This could reflect our determination to vaporize to the capsule in all vaporization cases BACKGROUND Plasmakinetic enucleation of the prostate ( PKEP ) has recently been proved a safe and technically feasible procedure for benign prostatic hyperplasia ( BPH ) . However , its long-term safety , efficacy , and durability in comparison with the gold-st and ard transurethral resection of the prostate ( TURP ) have not yet been reported . OBJECTIVE To report the 3-yr follow-up results of a prospect i ve , r and omised clinical trial comparing PKEP with st and ard TURP for symptomatic BPH . DESIGN , SETTING , AND PARTICIPANTS A total of 204 patients with bladder outflow obstruction ( BOO ) secondary to BPH were prospect ively r and omised 1:1 into either the PKEP group or the TURP group . INTERVENTION The patients in each group underwent the procedure accordingly . MEASUREMENTS All patients were assessed perioperatively and followed at 1 , 3 , 6 , 12 , 18 , 24 , and 36 mo postoperatively . The preoperative and postoperative parameters included International Prostate Symptom Score ( IPSS ) , quality of life ( QoL ) scores , the International Index of Erectile Function ( IIEF ) question naire , maximum urinary flow rates ( Q(max ) ) , transrectal ultrasound (TRUS)-assessed prostate volume , postvoid residual urine ( PVRU ) volume , and serum prostate-specific antigen ( PSA ) level . Patient baseline characteristics , perioperative data , and postoperative outcomes were compared . All complications were recorded . RESULTS AND LIMITATIONS PKEP was significantly superior to TURP in terms of the drop in haemoglobin ( 0.74±0.33 g/dl vs 1.88±1.06 g/dl ; p<0.001 ) , intraoperative irrigation volume ( 11.7±4.5 l vs 15.4±6.2 l ; p<0.001 ) , postoperative irrigation volume and time ( 18.5±7.6 l vs. 30.0±11.4 l and 16.6±5.2 h vs 25.3±8.5 h ; all p<0.001 ) , recovery room stay ( 67.3±11.1 min vs 82.0±16.4 min ; p<0.001 ) , catheterisation time ( 51.7±26.3 h vs 80.5±31.6 h ; p<0.001 ) , hospital stay ( 98.4±20.4 h vs 134.2±31.5 h ; p<0.001 ) , and resected tissue ( 56.4±12.8 g vs 43.8±15.5 g ; p<0.001 ) . There were no statistical differences in operation time and sexual function between the two groups . At 36 mo postoperatively , the PKEP group had a maintained and statistically significant improvement in IPSS ( 2.4±2.2 vs 4.3±2.9 ; p<0.001 ) , QoL ( 0.6±0.5 vs 1.6±1.4 ; p<0.001 ) , Q(max ) ( 28.8±10.1 ml/s vs 25.1±8.0 ml/s ; p=0.017 ) , and TRUS volume ( 21.0±7.3 ml vs 26.4±6.8 ml ; p<0.001 ) , with urodynamically proven deobstruction ( Schäfer grade 0.2±0.02 vs 0.8±0.1 ; p<0.001 ) . More extensive clinical trials are required to vali date these results . CONCLUSIONS PKEP is a safe and highly effective technique for relieving BOO . At 3-yr follow-up , the clinical efficacy of PKEP is durable and compares favourably with TURP OBJECTIVE Prospect ively evaluate perioperative outcomes and 2-yr follow-up after holmium laser enucleation ( HoLEP ) and st and ard open prostatectomy ( OP ) for treating benign prostatic hyperplasia-related obstructed voiding symptoms , with prostates > 70 g. METHODS From March 2003 to December 2004 , 80 consecutive patients were r and omised for surgical treatment with HoLEP ( n=41 ) or st and ard OP ( n=39 ) . All patients were preoperatively assessed with International Prostate Symptom Score and International Index of Erectile Function question naires and complete urodynamic evaluation . Intraoperative and perioperative parameters such as blood loss , catheter removal , and hospital stays were assessed . Early and late complications were recorded . Patients were evaluated at 1- , 3- , 12- , and 24-mo follow-ups with the same tests . RESULTS Operating room time was significantly shorter for the OP group ( 72.09+/-21.22 min vs. 58.31+/-11.95 min , p<0.0001 ) ; catheter removal ( 1.5+/-1.07 d and 4.1+/-0.5 d , p<0.001 ) and hospital stay ( 2.7+/-1.1 d vs. 5.4+/-1.05 d , p<0.001 ) were shorter in the HoLEP group . Blood loss was less and blood transfusions fewer in the HoLEP group ( p<0.001 ) . In both groups urodynamic and uroflowmetry findings improved from baseline , were still evident at the 24-mo follow-up , and were comparable between the two groups . Late complications were also comparable . CONCLUSIONS HoLEP is a feasible technique for treating large prostates . Functional results are similar to OP at the 2-yr follow-up . Reduced catheterisation , hospital stay , and blood loss make HoLEP an attractive option for the treatment of large prostates OBJECTIVES To compare the effectiveness and the safety of photoselective vaporization of the prostate ( PVP ) to open prostatectomy ( OP ) for the surgical treatment of large prostatic adenomas . METHODS A total of 125 patients with prostate gl and s > 80ml were r and omly allocated to PVP ( n=65 ) or OP ( n=60 ) and prospect ively evaluated at 1 , 3 , 6 , and 12 mo postoperatively . International Prostate Symptom Score ( IPSS ) and peak urinary flow rate ( Q(max ) ) were chosen as primary treatment-related end points . RESULTS The patients who underwent PVP experienced a longer length of operation time , shorter time of catheterization , and shorter hospital stay . Adverse events were minor and of similar profiles in both groups , although patients who underwent OP showed a higher transfusion rate . All functional parameters improved significantly compared to baseline values in both groups . The IPSS did not differ between the two groups at 3 , 6 , and 12 mo postoperatively . Patients who underwent OP scored better in the IPSS quality of life score at 6 and 12 mo postoperatively . No significant differences between the two groups in the Q(max ) , postvoid residual urine volume , and International Index for Erectile Function-5 question naire were detected . At 3 mo prostate volume was significantly lower in the OP group compared to the PVP group ( median value 10ml vs. 50ml ; p<0.001 ) and remained as such throughout follow-up , whereas prostate-specific antigen values reached statistical difference at 6 mo ( median value 2ng/ml vs. 2.4ng/ml ; p=0.028 ) . CONCLUSIONS Our results indicate that for a 12-mo period PVP is a highly acceptable treatment alternative to OP OBJECTIVE To perform a prospect i ve , r and omized , long-term comparison between bipolar plasma vaporization of the prostate ( BPVP ) , bipolar transurethral resection in saline ( TURis ) , and monopolar transurethral resection of the prostate ( TURP ) concerning the perioperative and follow-up parameters . METHODS A total of 510 patients with benign prostatic hyperplasia ( BPH ) , Q(max ) < 10 mL/s , International Prostate Symptom Score ( IPSS ) > 19 , and prostate volume between 30 and 80 mL were enrolled in the trial . All cases were evaluated preoperatively and at 1 , 3 , 6 , 12 , and 18 months after surgery by IPSS , quality of life , Q(max ) , and ultrasonography . RESULT Each study arm including 170 cases emphasized similar preoperative parameters . The capsular perforation and intraoperative bleeding rates as well as the mean hemoglobin drop were significantly decreased for BPVP by comparison with TURis and TURP . The postoperative hematuria , blood transfusion , and clot retention rates were significantly higher in the TURP group . The operation time was significantly shorter only for BPVP patients , whereas the catheterization period and hospital stay were significantly reduced for BPVP , followed by TURis . The rates of irritative symptoms and urethral strictures were similar in the 3 series . The recatheterization , bladder neck sclerosis , and retreatment rates were significantly lower in the BPVP group . During the 1 , 3 , 6 , 12 , and 18 months ' follow-up , the BPVP series emphasized significantly superior parameters in terms of IPSS and Q(max ) . CONCLUSION BPVP represents a valuable end 
    Output:
    
No significant difference was found in terms of short-term efficacy between bipolar transurethral resection of the prostate ( B-TURP ) and monopolar transurethral resection of the prostate ( M-TURP ) .
However , B-TURP was associated with a lower rate of perioperative complications .
Better short-term efficacy outcomes , fewer immediate complications , and a shorter hospital stay were found after holmium laser enucleation of the prostate ( HoLEP ) compared with M-TURP .
Compared with M-TURP , GreenLight photoselective vaporization of the prostate ( PVP ) was associated with a shorter hospital stay and fewer complications but no different short-term efficacy outcomes .
This meta- analysis shows that HoLEP is associated with more favorable outcomes than M-TURP in published RCTs .
B-TURP and PVP have result ed in better perioperative outcomes without significant differences regarding efficacy parameters after short-term follow-up compared with M-TURP .
PATIENT SUMMARY Bipolar transurethral resection of the prostate , photovaporization of the prostate , and holmium laser enucleation of the prostate have shown efficacy outcomes comparable with conventional techniques yet reduce the complication rate .