Tuesday, December 6, 2022

Transurethral Resection Of The Prostate Indication

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Is Walking Good After Prostate Surgery

Transurethral Resection of the Prostate (TURP)

Once you are ready, you should sit up and walk a few steps. Early walking is the key for fast recovery and return to bowel activity. It also improves blood circulation in the legs and prevents clot formation. The best way to a speedy recovery is to start walking the hallways on the day after surgery.

How Turp Is Performed

TURP is carried out using a device called a resectoscope, which is a thin metal tube containing a light, camera and loop of wire. This is passed along your urethra until it reaches your prostate, which means no cuts need to be made in your skin.

The loop of wire is then heated with an electric current and used to cut away the section of your prostate causing your symptoms. A thin tube called a catheter is then inserted into your urethra to pump fluid into the bladder and flush away pieces of prostate that have been removed.

General or spinal anaesthesia is used during the procedure so you don’t feel any pain while it’s carried out.

Tur Of The Prostate In The Oxford Medical Clinic

Urologic surgeries in the “Oxford Medical Kiev” are carried out in a new surgical hospital.

The operation itself usually lasts up to an hour and a half and is usually performed under general anesthesia. The postoperative period lasts from 3 to 7 days , discharge from the clinic, in most cases, is possible on the third or fourth day after surgery.

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What Happens After Transurethral Resection Of The Prostate

After your procedure is done, you go to a recovery area. Some people stay in the hospital for one to two days after TURP, others might be discharged the same day.

During your hospital stay, you have a catheter in your urethra. The catheter helps ensure that urine flows freely after your surgery. Usually, your healthcare provider removes the catheter before you go home.

What Are The Advantages Of Transurethral Resection Of The Prostate

Info

Benefits of TURP include:

  • Fast results: Most people notice an improvement in their urinary symptoms within a few days.
  • Treats severe BPH symptoms: TURP may be helpful if you have moderate to severe urinary problems from BPH and medications havent worked. Your healthcare provider may also recommend TURP if you have kidney stones, bladder stones or kidney damage from BPH.

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What Happens Before Transurethral Resection Of The Prostate

Although TURP doesnt use incisions, you need general anesthesia or spinal anesthesia during the procedure. Your healthcare provider will discuss which anesthesia option is best for you.

To prepare for anesthesia, you may need to stop eating and drinking several hours before your procedure. Tell your healthcare provider about all the medications and supplements you take, including blood thinners. Ask your healthcare provider whether you should stop taking any of them before your procedure.

Enhancing Healthcare Team Outcomes

TURP is typically an elective procedure used in the treatment of BOO. Because of this, appropriate indications and discussion of the complications associated with the procedure require an integrated interprofessional team to communicate effectively and initiate treatment plans, so the patient has proper expectations. This approach will ensure that patients are prepared for their procedure and what to expect. When patients are better informed, they are more invested in their decision and are happier with their outcome.

Collaboration shared decision making and communication are key elements for a good outcome. The interprofessional care provided to the patient must use an integrated care pathway combined with an evidence-based approach to planning and evaluation of all joint activities. The earlier signs and symptoms of a complication are identified, the better is the prognosis and outcome of the procedure.

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Less Common Side Effects Of Turp

Less common unwanted effects of surgery include:

  • urinary symptoms do not change sometimes surgery does not cure your urinary problems. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely, and nocturia
  • erectile dysfunction some men are unable to get or maintain an erection sufficient for sexual intercourse after surgery. This is more of a problem for men who had erectile difficulties before their operation. This problem may be treated by medication
  • urethral strictures when scarring occurs in and around the urinary tract, it can cause further blockage to urine flow. Strictures may need to be dilated or need further surgery
  • urinary incontinence sometimes surgery results in being unable to hold or control the flow of urine. This may be due to continuing bladder problems or, less often, to sphincter muscle damage

When Should I See My Healthcare Provider

Treating Benign Prostatic Hyperplasia (BPH)

Contact your healthcare provider if you notice:

  • New urinary symptoms, such as a weak stream or frequent urination.
  • Urine thats bright red or has clots in it.
  • Youre unable to urinate.

A note from Cleveland Clinic

TURP is a safe and effective procedure to treat urinary problems from BPH. However, this procedure may not be your only option. New advances in BPH treatment include nonsurgical, minimally invasive procedures that have a shorter recovery than TURP.

Your healthcare provider may recommend a BPH medication first. If medications dont work well, or if you have side effects to medications, you and your healthcare provider may discuss procedures like TURP to remove excess prostate tissue. The treatment you choose depends on your individual health history and your preferences. Together, you can create a BPH treatment plan that works for your needs and lifestyle.

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Newer Techniques Of Prostatic Resection

Newer techniques of prostatic resection use different types of energy to vaporize prostatic tissue and coagulate surrounding blood vessels. These techniques are reported to cause less haemorrhage than conventional TURP, but specimens for histology cannot be obtained. Since diathermy is not used, normal saline may be used as the irrigating solution, minimizing the risk of the TURP syndrome.

Minimally Invasive Procedures For Bph

Minimally invasive surgical therapies for BPH, such as free-beam laser therapy, radiofrequency ablation, transurethral needle ablation, prostatic urethral stents , and alcohol injection, are relatively simple procedures that can usually be performed in an outpatient setting, often with decreased postoperative catheterization time.

For patients at very high medical risk who cannot safely undergo significant anesthesia or surgery, these minimally invasive treatments may offer some benefit. Prostatic urethral stents, for example, have been suggested as a reasonable BPH treatment alternative when medical therapy has failed and the medical risks of surgery are unacceptably high. Stent migration, dysuria, and pain are relatively common complications but are easily reversible with stent removal.

These minimally invasive methods do not allow tissue to be saved for pathological analysis and do not remove the entire adenomatous prostate thus, retreatment and even TURP is sometimes required later. Up to 25% of patients who receive these minimally invasive treatment alternatives ultimately undergo a TURP within 2 years.

Prior to surgical intervention for LUTS attributed to BPH, clinicians should do the following:

  • Consider assessment of prostate size and shape via abdominal or transrectal ultrasound, cystoscopy, or by preexisting cross-sectional imaging
  • Assess post-void residual
  • Consider pressure flow studies when diagnostic uncertainty exists

Surgical Therapy

Simple prostatectomy:

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Transurethral Resection Of The Prostate

Indications

BPH is normally initially treated medically. This is done through alpha antagonists such as Flomax or alpha-1A reductase inhibitors such as Proscar and Avodart. If medical treatment does not reduce a patient’s urinary symptoms, a TURP may be considered following a careful examination of the prostate/bladder through a cystoscope. If TURP is contraindicated a Urologist may consider: a simple prostatectomy, in and out catheters, or a supra-pubic catheter to help a patient void urine effectively. As medical management of BPH improves, the numbers of TURPs have been decreasing.

Read more about this topic: Transurethral Resection Of The Prostate

How Can I Clean My Prostate

Pin on Prostate

10 diet & exercise tips for prostate health

  • Eat at least five servings of fruits and vegetables every day. …
  • Choose whole-grain bread instead of white bread and choose whole-grain pasta and cereals.
  • Limit your consumption of red meat, including beef, pork, lamb, and goat, and processed meats, such as bologna and hot dogs.
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    Which Doctor Is Best For Prostate Surgery

    Prostate Cancer Doctors in India

    • 91% Dr. Sudip Chakrabarty. …
    • 99% Dr. Arun Behl. Surgical Oncologist. …
    • 91% Dr. B Shiva Shankar. Urologist. …
    • 99% Dr. Rajesh Mistry. Surgical Oncologist. …
    • 91% Dr. Hemant Tongaonkar. Surgical Oncologist. …
    • 98% Dr. Dilip C Dhanpal. Urologist. …
    • 91% Dr. Shivashankar. Urologist. …
    • 98% Dr. JG Lalmalani. Urologist.

    What Are The Risks

    In most cases, TURP is a safe procedure and the risk of serious complications is very small.

    Some men also lose the ability to control their bladder , although this usually passes in a few weeks. In rare cases, it may be persistent and need further treatment.

    There’s also a small risk of problems such as erectile dysfunction, difficulties passing urine and urinary tract infections .

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    What Is The Recovery Time For Turp

    It takes four to six weeks to fully recover from TURP. Dont lift heavy objects, do strenuous exercise or have sex until your healthcare provider says its safe to do so. Dont drive or operate machinery if youre taking prescription pain medications.

    If your job doesnt require physical exertion, you may be able to return to work after two to three weeks. Ask your healthcare provider what they recommend for your time off work.

    What Happens During Transurethral Resection Of The Prostate

    Transurethral Resection of the Prostate – Detroit Medical Center

    Your healthcare provider performs TURP in a hospital operating room or ambulatory surgery center . The procedure usually takes less than 90 minutes. Youll receive anesthesia so you wont feel any pain.

    During your procedure, your healthcare provider:

    • Inserts a rectoscope into your urethra.
    • Examines your prostate and removes excess tissue with a laser or electrical current.
    • Uses fluid to temporarily flush the excess tissue into your bladder.
    • Drains any excess tissue out of your bladder through your urethra.
    • Removes the rectoscope.

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    Does Prostate Removal Shorten Life Expectancy

    After 23 years the men treated with radical prostatectomy gained a mean of 2.9 extra years of life. The researchers found that the absolute benefit associated with radical prostatectomy increased by a factor of more than two from 10 to 23 years’ follow-up in terms of overall mortality and disease specific mortality.

    What Is Transurethral Resection Of The Prostate

    Transurethral resection of the prostate, also called TURP, is surgery to remove part of your prostate gland. Your prostate gland is only found in men and people assigned male at birth , and wraps around your urethra . If your prostate gets too large, it can interfere with urination.

    During TURP, your healthcare provider inserts a thin tool into your urethra. This tool has an electric current or laser that allows them to remove part of your prostate. Because the tool goes in through your urethra, you dont have any incisions.

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    Why Turp Is Carried Out

    TURP is often recommended when prostate enlargement causes troublesome symptoms and fails to respond to treatment with medication.

    Symptoms that may improve after TURP include:

    • problems with starting to pee
    • a weak flow of pee, or stopping and starting
    • having to strain to pee
    • a frequent need to pee
    • waking up frequently during the night to pee
    • a sudden urge to pee
    • being unable to empty your bladder fully

    Is Urolift Better Than Turp

    Transurethral Resection of the Prostate

    Both Urolift and TURP lead to significant improvement in urinary function. In general, the urinary function is improved to a significantly high degree after the TURP procedure than after Urolift. The urine stream is improved by more than 100% after TURP while it improves only by about 30% after Urolift.

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      You must labour to acquire that great and uncommon talent of hating with good breeding, and loving with prudence to make no quarrel irreconcilable by silly and unnecessary indications of anger and no friendship dangerous, in care it breaks, by a wanton, indiscreet, and unreserved confidence.Philip Dormer Stanhope, 4th Earl Chesterfield

      It is difficult to write a paradiso when all the superficial indications are that you ought to write an apocalypse. It is obviously much easier to find inhabitants for an inferno or even a purgatorio.Ezra Pound

      The indications are that swearing preceded the development of cursing. That is, expletives, maledictions, exclamations, and imprecations of the immediately explosive or vituperative kind preceded the speechmaking and later rituals involved in the deliberate apportioning of the fate of an enemy. Swearing of the former variety is from the lips only, but the latter is from the heart. Damn it! is not that same as Damn you!

    Current Indications For Transurethral Resection Of The Prostate And Associated Complications

    Transurethral resection of the prostate is the most common surgical procedure for relieving symptoms of benign prostatic hyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohsiung Medical University Hospital . A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient, the surgical indication was categorized into acute urinary retention, chronic complications , and symptomatic prostatism. Thirty-five patients had acute urinary retention, 28 had chronic complications, and 48 had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to. Patients with acute urinary retention and chronic complications had larger prostates and more tissue resected than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP, especially when pyuria is noted preoperatively in patients with acute urinary retention.

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    Other Forms Of Treatment For Benign Prostate Disease

    Other forms of treatment may include:

    • monitor symptoms the condition is monitored closely. Treatment only begins once the condition has progressed and is causing problems
    • medical treatment symptoms of benign enlargement can be treated by medications that relax the muscles around the bladder or that shrink the prostate and delay the need for surgery.

    What Is The Difference Between Turp And Prostatectomy

    TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)

    Although open prostatectomy has better outcomes in larger prostates, TURP is limited to prostates of less than 80 to 100 g it seems reasonable that there is lower resected prostate weight in TURP than in open prostatectomy, especially in B-TURP , but there are scant data comparing similar resected tissue …

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    Development Of Benign Prostatic Hyperplasia

    Mechanisms of disease

    The prostate has been described as the organ of the body most likely to be involved with disease of some sort in men older than 60 years. This statement characterizes any histological evidence of BPH as a disease, which is certainly debatable, but there is no argument that BPH is an extremely common clinical entity.

    As the hyperplastic process increases the volume of the prostate, the urethral lumen is compressed, causing outlet obstruction. An enlarged median lobe may cause relatively more severe symptoms than lateral lobe hyperplasia of similar magnitude because it can act as a valve at which increased bladder pressure may actually cause further obstruction. Intravesical extension of the lateral lobes may act in a similar fashion.

    It has been known for many years, however, that prostate size alone is not a reliable or accurate predictor of the presence or degree of urinary outlet obstruction. The failure of several purely obstructive therapies, such as prostatic balloon dilatation, and the obvious success of alpha-adrenergic blockers eventually led to the description of BPH as having both a dynamic and a mechanical component.

    When a bladder is trying to empty through a blocked outlet from an obstructing prostate gland, the intravesical pressure required to open the bladder neck is increased. The bladder is initially able to produce a higher transitory voiding pressure when required, but loses muscle tone over time.

    Proposed causes

    Prostate Size And Blockage Of The Urethra

    If the inner part of the prostate gland obstructs the urethra during urination, this will irritate the bladder and cause urinary symptoms.Urinary symptoms may include:

    • frequent urination, particularly at night
    • urgency and possible urgency incontinence
    • passing drops of urine involuntarily after you think you’ve finished
    • blood in the urine although this can never be assumed to be due to the prostate until other causes have been excluded.

    The actual size of the prostate does not appear to determine whether or not there is a blockage. Some men with large prostates never develop obstruction, but some men with small prostates can have severe bladder obstruction, which causes difficulty with urinating.Around one in three Victorian men over the age of 50 years have some urinary symptoms. In most cases, these symptoms are due to a blockage caused by an enlarged prostate, but they may be due to other causes.

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    Contraindications For Transurethral Resection Of The Prostate

    • Large prostate adenomas should be treated with suprapubic simple prostatectomy
    • Need for bladder diverticula surgery: consider open prostatectomy at lower prostate gland volumes
    • Bladder stones: consider open prostatectomy depending on prostate volume and stone burden
    • Complex urethral disease like repaired hypospadia or repaired urethral stricture disease
    • Inguinal hernia: consider open prostatectomy and hernia repair at the same time

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