Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, United Kingdom.
J Endourol. 2009 Dec;23(12):2013-20. doi: 10.1089/end.2009.0129.
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.
经尿道前列腺切除术（TURP）综合征是一种罕见但潜在致命的综合征，其发病机制具有多因素性，目前对此有了更好的理解。不幸的是，尽管对此有了更好的认识，但它仍然没有过时，仍然存在风险。许多关于 TURP 综合征的综述都是从麻醉学的角度提出的；本综述反映了更多的泌尿科观点，强调了多学科管理这种复杂综合征的重要性。我们对 TURP 综合征进行了回顾，特别评估了对危险因素、发病机制以及预防该综合征的技术的理解进展。从开始到 2009 年 4 月，我们系统地在 Medline、Embase、Cochrane 对照试验登记处和效果摘要数据库中检索了关键词 TUR（P）、TUR（P）综合征和经尿道前列腺切除术。我们的搜索没有语言限制。随机对照试验、综述文章和病例系列都包含在我们的搜索中。我们的综述显示，尽管 TURP 仍然是治疗良性前列腺梗阻的金标准，但 TURP 综合征的发病率呈下降趋势。采用一系列激光技术的技术进步、使用双极电路以及培训技术的进步有助于最大限度地降低这种综合征的发生风险。本综述展示了 TURP 综合征的复杂性。即使对发病机制有了更深入的了解，它也强调了从发病症状、预防措施和管理来看，该综合征的不可预测性。TURP 综合征不能按照方案进行，需要保持警惕、高度怀疑、强化监测以及多学科方法。
