Efficacy and Safety of En-Bloc Laser Enucleation of the Prostate for Benign Prostatic Obstruction: An Evidence-Based Analysis of Clinical Studies

Background and objective 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).Methods 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.Results 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.Conclusions 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.