Transurethral resection of the prostate syndrome: almost gone but not forgotten.
نویسندگان
چکیده
Transurethral resection of the prostate (TURP) syndrome is a rare but potentially fatal syndrome with multifactorial pathophysiology that is now better understood. Unfortunately, despite this improved understanding, it is not yet obsolete and still remains a risk. Many reviews of TURP syndrome have been presented from an anesthetic perspective; this review reflects more the urologic perspective with emphasis on the importance of multidisciplinary management of this complex syndrome. We present a review of TURP syndrome that specifically assesses advances in the understanding of risk factors, pathophysiology, and techniques used to prevent this syndrome. The databases Medline, Embase, Cochrane Controlled Trial Register, and Database of Abstracts of Reviews of Effects were systematically reviewed from inception to April 2009 for the keywords TUR (P), TUR (P) syndrome, and transurethral resection of prostate. There was no language restriction for our search. Randomized controlled trials, review articles and case series were included in our search. Our review showed a declining trend in the incidence of TURP syndrome despite TURP remaining the gold standard for the management of benign prostatic obstruction. Technologic advances using an array of laser techniques, the use of bipolar circuitry, together with advances in training techniques have helped minimize the risk of development of this syndrome. This review demonstrates the complexity of TURP syndrome. Even with a greater understanding of the pathophysiology, it highlights the unpredictability of the syndrome from presenting symptoms, preventative measures, and management. TURP syndrome cannot be protocol driven and the need for vigilance, a high index of suspicion, intensive monitoring, and a multidisciplinary approach is vital.
منابع مشابه
EXPERIENCE WITH BLADDER NECK INCISION TO RELIEVE BLADDER OUTLET OBSTRUCTION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE IN SHIRAZ
TUR is cited as the treatment of choice for relief of bladder outflow tract obstruction in the male, but bladder neck incision (BNI) is an acceptable alternative when the gland is smalI.1,2,3 Sixty cases of BNIfTUR have been reviewed (BNI=35, TUR=25) from March, 1986 to April, 1988. BNI was done when the glands were less than 30 gr , and when there was no clinical suspicion of malignancy t...
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ورودعنوان ژورنال:
- Journal of endourology
دوره 23 12 شماره
صفحات -
تاریخ انتشار 2009