University of Melbourne, Department of Surgery, Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, Melbourne, Vic 3084, Australia.
Nat Rev Urol. 2011 Aug 16;8(9):504-14. doi: 10.1038/nrurol.2011.106.
Transurethral resection of the prostate (TURP) is the most common surgical treatment for benign prostatic hyperplasia (BPH) worldwide, but despite its minimally invasive nature, perioperative bleeding remains a common morbidity. Anticoagulant and antiplatelet medications are increasingly common in this patient population and further contribute to the risk of bleeding and extended hospital stay. Preoperative cessation of anticoagulant and antiplatelet drugs is recommended but requires risk assessment of thrombotic complications. Pharmacologic maneuvers to reduce hemorrhage include perioperative administration of 5α-reductase inhibitors. Technical considerations include the use of hemostatic energy sources such as laser and bipolar technologies. Ultimately, no surgical technique is devoid of bleeding risks, and urologists should be aware of how best to prevent and treat TURP-related hemorrhage.
经尿道前列腺切除术（TURP）是目前全世界治疗良性前列腺增生（BPH）最常用的手术方法，但尽管其具有微创性，围手术期出血仍然是一种常见的并发症。在这类患者人群中，抗凝和抗血小板药物的应用越来越普遍，进一步增加了出血和延长住院时间的风险。推荐术前停止使用抗凝和抗血小板药物，但需要评估血栓并发症的风险。减少出血的药物治疗方法包括围手术期使用 5α-还原酶抑制剂。技术方面的考虑因素包括使用激光和双极技术等止血能源。最终，没有任何一种手术技术可以完全避免出血风险，泌尿科医生应该了解如何最好地预防和治疗 TURP 相关的出血。
