TURP

1. TRANSURETHRAL
RESECTION OF THE
PROSTATE

2. WHAT IS THE PROSTATE?
 a gland about the size of a walnut.
 found just below the bladder.
 surrounds the urethra, the tube that carries urine
out of the bladder. The prostate produces a fluid
that helps the sperm move and provides
nourishment for the sperm.

3. DEFINITION
 Transurethral resection of the prostate (TURP) is
surgery to remove all or part of the prostate gland,
to treat an enlarged prostate.

4. INDICATIONS OF TURP
 Obstructive uropathy related to Benign Prostatic
Hypertrophy
 Acute urinary retention related to prostatic
hypertrophy
 Recurrent urinary infections or febrile urinary
infection related to benign prostatic hypertrophy
 Recurrent bleeding from the prostate
 Bladder stones with prostate enlargement
 Increased pressure on the ureters and kidneys
(hydronephrosis) from urinary retention

7. CONTRAINDICATIONS OF TURP
 Unstable cardiopulmonary status & History of
uncorrectable bleeding disorders
 Patients with a recent myocardial infarction or coronary
artery stent placement
 Patients who cannot be safely taken off blood thinners
(plavix)
 Patients with myasthenia gravis, multiple sclerosis, or
Parkinson disease
 Patients who have recently completed definitive
radiation therapy for prostate cancer
 Patients with prostate cancer who are considering
brachytherapy (radioactive seed implantation) or
cryotherapy as part of their definitive treatment
 Active Urinary Tract Infection

8. COMPLICATIONS
 TURP Syndrome
 Incontinence
 Retrograde ejaculation
 Thrombophlebitis
 Excessive bleeding
 Infection

9. EQUIPMENTS
 Resectoscope/Cystoscope
 Bowl/Irrigation tray
 Russian Forcep
 Distilled water (for cystoclysis)
 3 way catheter/ Foley catheter with drainage bag
 Electrocautery Loop
 Syringe (10 cc)
 OS
 Kidney basin (atleast 2)
 Surgical gloves, gown, mask and cap
 Lubricant

10. RESECTOSCOPE

13. NURSING
MANAGEMENT

14. PREOPERATIVE CARE
 Preoperative assessment
 Proper explanation of surgical procedure
 Proper explanation of the complications and risks
 Ensure that informed consent has been signed
 Notify physician for allergies
 Notify physician of all medications taken
 Notify for history of bleeding disorders

15. INTRAOPERATIVE CARE
 Maintain Safety and Prevent Injury
 Position in Client
 Provide Equipment Safety
 Maintain Surgical Asepsis
 Assist in Wound Closure
 Monitoring:
 –V/S (Body temperature)
 –Malignant Hyperthermia
 –Cardiac Respiratory Arrest
 Allergic Reactions

17. POST OPERATIONAL PHASE
 Maintaining patency of catheter system
 Monitoring urine appearance
 Monitoring signs of water intoxication
 Avoid enemas and rectal thermometer use
 Instruct patient not to void around catheter
 Give prescribed medications
 After catheter removal
 Frequently change dressings
 Give opportunities to discuss any concerns
 Do health teachings to client

18. THANK YOU!