This document discusses transurethral resection of the prostate (TURP), a surgery to remove part or all of the enlarged prostate gland to treat conditions like benign prostatic hypertrophy. It describes the prostate's location and function, indications for TURP like urinary retention, contraindications like recent radiation therapy or bleeding disorders, potential complications, the surgical equipment used, and the nurse's role in pre-operative, intra-operative, and post-operative care of the patient.

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!