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Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
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Prevention and management of TURP-related hemorrhage

Liam E Kavanagh1, Gregory S Jack, Nathan Lawrentschuk

  • 1University of Melbourne, Department of Surgery, Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, Melbourne, Vic 3084, Australia.

Nature Reviews. Urology
|August 17, 2011
PubMed

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.

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