{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:16Z","timestamp":1788847636721,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Objective<\/jats:title>\n To systematically evaluate the efficiency and safety of different prostate morcellators used during prostate enucleation for benign prostatic hyperplasia (BPH).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta\u2010analyses guidelines.\n PubMed<\/jats:styled-content>\n \/Medline, Scopus, and Web of Science were searched for studies published between October 2012 and May 2025. Studies reporting clinical outcomes of morcellators used during prostate enucleation were included. Primary outcome was morcellation efficiency (g\/min). Secondary outcomes included intraoperative complications, device malfunction, and cost when available. Risk of bias (RoB) was assessed using the Risk Of Bias In Non\u2010randomised Studies of Interventions (\n ROBINS<\/jats:styled-content>\n \u2010I),\n RoB<\/jats:styled-content>\n 2 tool, and European Association of Urology case\u2010series criteria. Random\u2010effects meta\u2010analyses and multilevel meta\u2010regression adjusted for prostate volume were conducted.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 22 studies comprising 5980 patients were included, most undergoing holmium laser enucleation of the prostate. The most frequently evaluated devices were the Piranha\u2122 (Richard Wolf GmbH, Knittlingen, Germany) and Lumenis\n VersaCut\u2122<\/jats:styled-content>\n (Lumenis Ltd., Yokneam, Israel; 12 and 13 studies, respectively), followed by\n DrillCut\u2122<\/jats:styled-content>\n (Karl Storz SE & Co. KG, Tuttlingen, Germany),\n MultiCut\u2122 (Asclepion Laser Technologies GmbH, Jena, Germany)<\/jats:styled-content>\n , and Cyber Blade\u2122 (Quanta System SpA, Milan, Italy) systems. Unadjusted weighted mean morcellation efficiency was 7.80\u2009g\/min (95% confidence interval [CI] 6.26\u20139.34\u2009g\/min) for Piranha, 4.70\u2009g\/min (95% CI 3.61\u20135.79\u2009g\/min) for\n VersaCut<\/jats:styled-content>\n , 5.90\u2009g\/min (95% CI 3.16\u20138.64\u2009g\/min) for\n DrillCut<\/jats:styled-content>\n , and 9.59\u2009g\/min (95% CI 4.78\u201314.39\u2009g\/min) for\n MultiCut<\/jats:styled-content>\n . In volume\u2010adjusted meta\u2010regression using Piranha as reference,\n VersaCut<\/jats:styled-content>\n remained significantly less efficient (\u22122.75\u2009g\/min; 95% CI \u22124.58 to \u22120.92\u2009g\/min;\n P<\/jats:italic>\n \u2009=\u20090.003), with an even greater difference in prostates >70\u2009mL (\u22124.34\u2009g\/min). Bladder mucosal injury was the most frequently reported complication; however, relatively rare across all devices. Meta\u2010analysis demonstrated a significantly higher risk with\n VersaCut<\/jats:styled-content>\n compared to Piranha (risk ratio 3.22, 95% CI 1.81\u20135.71), with low heterogeneity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This systematic review provides a contemporary clinical benchmark of the efficiency and safety of currently available prostate morcellators. Oscillating blade systems, particularly the Piranha morcellator, demonstrated higher morcellation efficiency and a more favourable safety profile than reciprocating blade devices, with the largest performance differences observed in patients with larger prostates.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70362","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T02:58:15Z","timestamp":1783565895000},"page":"537-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prostate morcellation devices: a systematic review and meta\u2010analysis of clinical outcomes and efficiency"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5411-6274","authenticated-orcid":false,"given":"Stessy","family":"Kutchukian","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, GRC n\u00b039, Sant\u00e9 de l'homme H\u00f4pital Tenon Paris 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