TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)

DEFINITION

• Surgical procedure involving removal of prostate tissue using resectoscope

inserted through a urethra.

• Widely used technique for managing BPH(Benign Prostatic

Hypertrophy/Hyperplasia)

INDICATIONS

• BPH (Benign Prostatic Hyperplasia/ Hypertophy)

• Enlarged lateral lobes of the prostate
• Enlarged median lobes

SURGICAL POSITION

---LITHOToMY

SURGICAL AREA:

SURGICAL PROCEDURE

--Resectoscope is inserted
--cystoscope is inserted
---Movable loop
---cold punch resectoscope (circular knife)
--irrigating fluid is infused (isotonic)

BPH (Benign Prostatic Hyperplasia/ Hypertophy)

--prostate growth sufficiently obstructs the urethral outlet

-testosterone (ANDROGEN )

-dihydrostestosterone (DHT)

-5-alpha reluctase

--other factors

--defect in local substances

e.g local inflammation
e.g genetic factors
--Dietary lifestyles, smoking, alcohol intake

Manifestations

-daytime urinary frequency

-LUTS(Lower Urinary Tract Symptoms)
-- nocturia
--- intermittent urinary stream
--incomplete bladder emptying

SURGICAL OPERATION

NURSING MANAGEMENT of the SURGICAL CLIENT

PREOPERATIVE CARE

1.) Assess the client’s ability to empty his bladder.

2.) Assess client in the intake of drugs or supplements (anticoagulants)
3.) Assessment of expectations in the changes of voiding and sexual function.
4.) Respond to the concerns of the client and significant others in empathetic
listening.
5.) Restating explanations (Informed consent)

POSTOPERATIVE CARE

1.)Observe V/S and urinary drainage. (closed bladder irrigation)

2.) frequently assess client’s urine output.
3.) Ensure catheter patency

DIAGNOSIS and INTERVENTIONS

DIAGNOSIS:

RISK FOR INJURY r/t to presence of urinary catheters, hematuria.

INTERVENTIONS:

1.) Maintai n Irrigation

2.) Practice good meatal care atleast 2 times a day.
 3.) Monitor bleeding
4.) Prevent catheter dislodgment
5.) Prevent infection
6.) Monitor for retention
7.) Manage Temporary Incontinence

DIAGNOSIS:

ACUTE PAIN r/t surgery and bladder spasms

1.)Pain control
--Antispasmodec meds.
---stool softeners

SELF CARE

1.) Provide Teaching

2.) Prevent Injury
3.) Teach Pelvic Muscle Rehabilitation
4.) Treat Erectile Dysfunction
5.) Arrange follow-up

Reference

---Black, Joyce, et. al (2005).Medical Surgical Nursing: Clinical Management for

Positive OutcomesVol.1 7th edition ..pp 1013-1027

---http:// evolve.elsevier.com/Black/medsurg