Transurethral resection of the prostate (TURP)

Transurethral resection of the prostate (TURP)

1. TURP: Transurethral Resection of the Prostate

2. PRESENTERS Goodlucky Evarist Marandu Jofrey Mtewele Agness Nhonya Venance Jackson Fahmi Omary Charles Ghuliku Jackline Lugongo Boniface Lusana Mwijuma Tamimu Rehema Sulle Martha Mlay Colman Ngowi

3. BPH Benign prostatic hyperplasia is the non malignanct growth of prostate that gradually cause urinary obstruction. BPH is not cancer .It is a common part of aging. It begin around age of 50 years.

4. BPH-02 Current studies shows that BPH does not increase a man's risk of developing cancer of prostate As the size of prostate gland increases it begin to compress urethra. hence longer time is needed to empty blader, eventually the narrowing may lead to urinary rentention or hydronephrosis

5. INTRODUCTION OF TURP A transurethral resection of the prostate (TURP) is surgery to remove parts of the prostate gland through the penis. No incisions are needed. The surgeon reaches the prostate by putting an instrument into the end of the penis and through the urethra

6. Introduction 02 This instrument is called a resectoscope it contains a lighted camera and valves that control irrigating fluid. It also contains an electrical wire loop that cuts tissue and seals blood vessels. The wire loop is guided by the surgeon to remove the tissue blocking the urethra.

7. Introduction 03 The pieces of tissue are carried by the irrigating fluid into the bladder and then flushed out at the end of the procedure TURP is usually performed in the lithotomy position with a slight Trendelenburg tilt.

8. IRIGATION SOLUTION An irrigation solution for TURP should be isotonic, electrically inert, nontoxic, transparent, easy to sterilize,and inexpensive. Commonly used are solutions of glycine, 1.2%and 1.5%;mannitol, 3% to 5%; glucose , 2.5% to 4%; sorbitol, 3.5%; Cytal (a mixture of sorbitol, 2.7%, and mannitol, 0.54%); and urea, 1%

9. Anesthetic Techniques Spinal anesthesia is the most frequently used anesthetic for TURP and is believed to be the technique of choice by many. A spinal anesthetic provides adequate anesthesia for the patient and good relaxation of the pelvic floor and the perineum for the surgeon.

10. Anesthetic Techniques 02 General anesthesia may be necessary in patients who require ventilatory or hemodynamic support, have a contraindication to regional anesthesia, or refuse regional anesthesia.

11. INSTRUMENTS FOR TURP Resectoscope Elic evacuator bottle Shif and jag Working element Telescope

12. Instruments-02

13. INDICATION FOR TURP TURP is most often done to relieve symptoms caused by an enlarged prostate. This is often due to benign prostate hyperplasia (BPH ). Urinary rentetion

14. Indication 02 Sometimes a TURP is done to treat symptoms only, not to cure the disease. For example, if you’re unable to urinate because of prostate cancer, but surgery to remove the prostate isn’t an option for you, you may need a TURP

15. COMPLICATION OF TURP Certain complications can occur with TURP. Some possible complications may include: Bladder injury Bleeding Blood in the urine after surgery Electrolyte abnormalities Infection Loss of erections Painful or difficult urination Retrograde ejaculation

16. COMPLICATION OF TURP

17. Absorption of Irrigating Solution Because the prostate gland contains large venous sinuses, it is inevitable that irrigating solution will be absorbed. Excessive absorption of modern irrigation solutions might lead to other complications, such as pulmonary edema and electrolytes imbalance.

18. Perforation Perforations usually occur during difficult resections and are most often made by the cutting loop or knife electrode. Most perforations are extra peritoneal, and in a conscious patient they result in pain in the periumbilical, inguinal,or suprapubic regions.

19. TURP syndrome TURP syndrome is a term applied to a constellation of symptoms and signs caused primarily by excessive absorption of irrigating fluid.

20. Treatment of TURP syndrome Consists of fluid restriction and a loop diuretic such as furosemide.

21. NURSES ROLE Preparation of the instruments Performing checklist with team Irrigation during procedure Taking care of instruments after surgery

22. REFERENCES http://www.urology-textbook.com/turp-prostate-resection.html

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