Transurethral resection of the prostate (TURP)

1. TURP: Transurethral Resection of
the Prostate

2. PRESENTERS
1. Goodlucky Evarist Marandu
2. Jofrey Mtewele
3. Agness Nhonya
4. Venance Jackson
5. Fahmi Omary
6. Charles Ghuliku
7. Jackline Lugongo
8. Boniface Lusana
9. Mwijuma Tamimu
10. Rehema Sulle
11. Martha Mlay
12. 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.

9. 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%

10. 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.

11. 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.

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

13. Instruments-02

14. 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

15. 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

16. 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

17. COMPLICATION OF TURP

18. 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.

19. 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.

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

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

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

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