Open Access
REVIEW
Efficacy and safety of blue laser vaporization of the prostate for benign prostatic hyperplasia: a systematic review and meta-analysis
Ren-Peng Yu1,2,3, Ou-Yang Song1, Hong Weng2,3, Yong-Bo Wang2, Bing-Hui Li2, Hao Zi4, Yu Hao1, Qiang Li1,*, Xian-Tao Zeng1,2,3,*
1 Department of Urology, The First Affiliated Hospital of Shihezi University, Shihezi, China
2 Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
3 Department of Urology, Hubei Key Laboratory of Urinary System Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China
4 Evidence-Based Medicine Center, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
* Corresponding Author: Qiang Li. Email: 
; Xian-Tao Zeng. Email: 
, 
Canadian Journal of Urology https://doi.org/10.32604/cju.2026.079426
Received 21 January 2026; Accepted 26 March 2026; Published online 30 April 2026
Abstract
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.
Keywords
benign prostatic hyperplasia; blue laser vaporization of the prostate; transurethral resection of the prostate; greenlight laser vaporization of the prostate; 1470 nm diode laser enucleation of the prostate; systematic review; meta-analysis
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