Ren-Peng Yu, Ou-Yang Song, Hong Weng, Yong-Bo Wang, Bing-Hui Li, Hao Zi, Yu Hao, Qiang Li, Xian-Tao Zeng
Preliminary evidence suggests that BLVP appears to be a safe and effective minimally invasive procedure for BPH, demonstrating favorable trends in perioperative recovery and sexual function preservation. However, due to a lack of high-quality RCTs and low-to-moderate certainty of evidence, BLVP's equivalence or superiority to TURP remains inconclusive, warranting further large-scale trials.
OBJECTIVE: While novel 450 nm blue laser vaporization of the prostate (BLVP) has emerged as a promising treatment for benign prostatic hyperplasia (BPH), comprehensive evidence-based validation remains lacking. Therefore, this study aims to evaluate the efficacy and safety of BLVP for BPH.
METHODS: A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang database up to 1 September 2025 (an updated search was performed on 31 December 2025). Single-arm meta-analyses summarized the absolute efficacy and safety of BLVP. For the comparison of BLVP with other surgical procedures, head-to-head meta-analyses or descriptive systematic reviews were performed based on the homogeneity of studies.
RESULTS: Across 23 included studies (1713 participants), single-arm meta-analysis showed favorable perioperative outcomes: mean operative time (26.46 min), bladder irrigation time (14.96 h), catheterization time (2.67 d), and hemoglobin drop (6.96 g/L). Postoperative IPSS, Qmax, PVR, and QoL significantly improved with low complication rates. Compared with transurethral resection of the prostate (TURP), BLVP demonstrated favorable outcomes regarding shorter operation, irrigation, and catheterization times, less hemoglobin loss, and shorter hospital stays (all p < 0.05). While urinary functional recovery was comparable, BLVP exhibited lower risks of urinary incontinence (OR = 0.38) and secondary bleeding (OR = 0.15). Additionally, BLVP better preserved sexual function, demonstrating higher International Index of Erectile Function-5 (IIEF-5) scores at 6 months and a significantly lower incidence of retrograde ejaculation (OR = 0.07) than TURP. Preliminary studies suggest that the efficacy of BLVP is similar to that of 1470 nm and greenlight lasers.
CONCLUSION: Preliminary evidence suggests that BLVP appears to be a safe and effective minimally invasive procedure for BPH, demonstrating favorable trends in perioperative recovery and sexual function preservation. However, due to a lack of high-quality RCTs and low-to-moderate certainty of evidence, BLVP's equivalence or superiority to TURP remains inconclusive, warranting further large-scale trials.