Prostate resection, transurethral

Antibiotic prophylaxis is warranted in high-risk patients (e.g., prolonged indwelling catheterization, positive urine cultures, and neutropenia) undergoing transurethral, perineal, or suprapubic resection of the prostate, resection of bladder tumors, or cystoscopy. 

Blodgett and his associates studied aspartate aminotransferase values in 33 patients before and after transurethral prostatic resection (B14). In only two patients was there an elevation. Forty-seven percent of 51 patients who were in accidents involving bodily trauma without any... 

B14. Blodgett, R. C., Anderson, N. W., McGockin, W. F., and Fleisher, G. A., Glutamic oxaloacetic transaminase activity in serum after transurethral prostatic resection. Arch. Intern. Med. 114, 344-347 (1964). 

Olsson J, Rentzhog L, Hjertberg H, Hahn RG. Reliability of clinical assessment of fluid absorption in transurethral prostatic resection. Eur Urol 1993 24(2) 262-6. 

Hahn RG. Hallucination and visual disturbances in transurethral prostatic resection. Intensive Care Med 1988 I4(6) 668-7I. 

With transurethral prostate resection the bladder has to be irrigated with large quantities of solution to ensure that the view during the operation is not reduced by the presence of blood. 

A greater change in serum sodium may be required if severe signs/symptoms secondary to hyponatremia persist. Another exception may be hyponatremia occurring in the setting after transurethral resection of the prostate (TURP)... 

Unless the sphincter mechanism is compromised by surgery or trauma, SUI is exceedingly rare in males. The most common surgeries predisposing to SUI in males are radical prostatectomy for prostate cancer and transurethral resection of the prostate for benign prostatic hyperplasia. 

SMA-12 Glucose, BUN, uric acid, calcium, phosporous, total TURP Transurethral resection of the prostate... 

Benign prostatic hyperplasia (BPH) (Prascar on/yj.Treatment of symptomatic BPH in men with an enlarged prostate to improve symptoms, reduce acute urinary retention risk, and reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy. 

Coagulative effect. Permixon, administered to 108 patients at a dose of 320 mg/ day for at least 8 weeks before the procedure of transurethral resection of prostate, produced significantly lower bleeding than in the control (124 vs 287 mL, respectively), and the need of transfusion decreased remarkably. The duration of postoperative catheterization (3 vs 5 days, respectively) and the evaluated hematological parameters (red cells 4.5 vs 4 million, hemoglobin 13.4 vs 11.9 g, hematocrit 40 vs 35%) were significantly lower than in the control group . 

Gambardella, and G. Sepe. Efficacy of pretreatment with Serenoa repens on bleeding associated with transurethral resection of prostate. Minerva Urol Nefrol 2004 56(1) 73-78. 

Thomas D, Hales P. Overhydration during transurethral resection of the prostate using glycine as an irrigating solution. Anesth Intensive Care 1984 12 366-369. 

An 86-year-old man, who was taking captopril 25 mg bd and bendroflumethiazide 25 mg/day for hypertension, had a transurethral resection of the prostate under spinal anesthesia, and developed profound bradycardia and hypotension with disturbances of consciousness during transfer to the recovery room (18). Initial treatment with atropine produced rapid improvement in cardiovascular and cerebral function. A further hypotensive episode, without bradycardia, occurred about 1 hour later, but responded rapidly to methoxamine. He made a full recovery overnight. 

After transurethral resection of his prostate, a 68-year-old man developed immune thrombocjdopenic purpura (platelet count 1 x 10 /1) (14). He had self-medicated with cranberry juice for 10 days before the operation and had also taken amlodipine and aspirin. He had oral petechiae, bleeding gums, hematuria, and bruises. He recovered within 3 days of being given human immunoglobulin and oral prednisolone, and 18 months later his platelet count was still normal. 

Norlen H, Dimberg M, Allgen LG, Vinnars E. Water and electrolytes in muscle tissue and free amino acids in muscle and plasma in connection with transurethral resection of the prostate. II. Isotonic 2.2% glycine solution as an irrigating fluid. Scand J Urol Nephrol 1990 24(2) 95-101. 

Mannitol is an osmotic diuretic that has been used in acute oliguric renal insufficiency, acute cerebral edema, and the short-term management of glaucoma, especially to reduce intraocular pressure before ophthalmic surgery. Other indications include promotion of the excretion of toxic substances by forced diuresis, bladder irrigation during transurethral resection of the prostate, and oral administration as an osmotic laxative for bowel preparation. Mannitol is used as a diluent and excipient in pharmaceutical formulations and as a bulk sweetener. 

The first study where the SCS was applied to MRS analysis of prostate biopsies was undertaken at the IBD in Winnipeg.42 Proton MRS (Bruker Instruments, 8.5 T were performed at 37°C on specimens of benign (n = 66) and malignant (n = 21) human prostate tissue specimens collected from transurethral resection of the prostate and radical prostatectomy from 50 patients. Typical spectra of malignant prostate tissue and benign prostate hyperplasia (BPH) are shown in Fig. 5.42 The spectral data were subjected to visual inspection analysis and multivariate analysis, specifically LDA. 

The metabolic clearance rate of PSA follows a two-compartment model with initial half-lives of 1.2 and 0.75 hours for free PSA and total PSA and subsequent half-lives of 22 and 33 hours. Because of this relatively long half-life, 2 to 3 weeks may be necessary for the serum PSA to return to baseline levels after certain procedures, including transrectal biopsy, transrectal ultrasonography, transurethral resection of the prostate, and radical prostatectomy. Prostatitis and acute urinary retention can also elevate PSA concentration. Although the digital rectal examination has no clinically important effects on serum PSA levels in most patients, in some it may lead to a twofold elevation. 

Pharmaceutical treatments for this common but annoying condition include finasteride (trade name Proscar) and terazosin (trade name Hytrin). Surgical procedures include the TURP procedure (transurethral resection of the prostate) and balloon dilation. 

Agarwal R, Emmett M. The post-transurethral resection of prostate syndrome Therapeutic proposals. Am J Kidney Dis 1994 24 108-111. 

In patients who have complications of BPH, surgery is required. Although it has more adverse complications than does pharmacotherapy or watchful waiting, transurethral resection of the prostate is considered the gold standard. 

Wasson JH, RedaDJ, Bruskewitz RC, etal, fordie Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. N Engl J Med 1995 332 75-79. 

Christensen MM, Aagaard J, Madsen PO. Transurethral resection versus transurethral incision of the prostate A prospective randomized study. Urol Clin North Am 1990 17 621-630. 

In men, SUI is most commonly the result of prior lower urinary tract surgery or injury, with resulting compromise of the sphincter mechanism within and external to the urethra. Radical prostatectomy for treatment of adenocarcinoma of the prostate is probably the most common setting in which surgical manipulation leads to UI. Overall, SUI in the male is uncommon, and in the absence of prior prostate surgery, severe trauma, or neurologic illness, is extraordinarily rare. Transurethral resection of the prostate for benign prostatic hyperplasia (see Chap. 82) may also lead to SUI in men. 

TIPS transjugular intrahepatic portosystemic shunt TURP transurethral resection of the prostate VRE vancomycin-resistant enterococci... 

Adenosis and sclerosing adenosis are most commonly seen in transurethral resection of the prostate specimens. 

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