transurethral resection of prostate procedure

2. Outline of presentation
• Indications
• Surgical anatomy
• Pre-op considerations
• Surgical technique
• Post op management and complications

3. Surgical Anatomy

4. Absolute indications
• Refractory urinary retention
• Recurrent urinary retention
• Recurrent haematuria refractrory to medical treatment with 5 alfa
reductase inhibitors
• Bladder stone
• Renal insufficiency

5. Relative indications
• Morphological changes in bladder or upper urinary tract secondary to BOO
such as bladder diverticulum and HDN
• Postvoid residual> 100 ml
• Recurrent urinary infection secondary to BOO
• Patient willingness for surgery

6. Contraindications
• Absolute contraindication are active urinary tract infection and uncorrected
coagulopathy
• Relative contraindication-larger bladder stone

7. Preoperative Preparation
Stop aspirin 1 week before operation.
Rule out and treat any urinary tract infection by urine culture and
sensitivity.
Thrombosis prophylaxis should be started
the evening before operation (low-molecular-weight heparin).
Rectal enema is used the day before the operation.
Intravenous single dose antibiotics are started at induction

10. Steps of surgery

14. Postoperative Care
• When the irrigation fluid becomes clear catheter traction can be released up
to 4 h.
• Continue irrigation of the bladder overnight.
• If there is no complication, the catheter can be removed 2 days after
operation

16. Freyer’s prostatectomy

17. Steps of surgery

20. Thank you