Transurethral resection of the prostate

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. 

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. 

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. 

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. 

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. 

Herawi M, Epstein JI. Solitary fibrous tumor on needle biopsy and transurethral resection of the prostate a clinicopathologic study of 13 cases. Am J Surg Pathol. 2007 31 870. 

The UAP measures the output of a client who had a transurethral resection of the prostate. 

The client who has had a transurethral resection of the prostate is complaining of bladder spasms. The HCP prescribed an opiate suppository, belladonna and opiate (B O). Which is the first action the nurse should take when administering this medication ... 

The client diagnosed with benign prostatic hypertrophy has had a transurethral resection of the prostate (TURP). The client is complaining of lower abdominal pain. Which intervention should the nurse implement Rank in order of performance. 

In a comparison of 5 mg of hjrperbaric bupivacaine 0.5%-I-morphine either 25 or 50 micrograms in 70 patients undergoing transurethral resection of the prostate, those who received the higher dose of morphine had a higher incidence of pruritus, but none required antipruritic medications and patient satisfaction was good or excellent [129. ... 

Duman A, Apiliogullari S, Balasar M, Gurbuz R, Karcioglu M. Comparison of 50 mug and 25 mug doses of intrathecal morphine on postoperative analgesic requirements in patients undergoing transurethral resection of the prostate with intrathecal anesthesia. J Clin Anesth 2010 22 329-33. 

Local administration of adrenaline may cause hypertension. In an intraprostatic adrenaline administration during transurethral resection of the prostate caused hypertensive crisis in one patient (7.7%) [261. 

Lira-Dale A, Maldonado-Avila M, Gil-Garcia JF, Mues-Guizar EH, Nerubay-Toiber R, Guzman-Esquivel J, et al. Effect of intraprostatic epinephrine on intraoperative blood loss reduction during transurethral resection of the prostate. Int Urol Nephrol 2012 44(2) 365-9. 

---