A patient undergoing a Transurethral Resection of the Prostate (TURP) procedure is typically a man with an enlarged prostate gland (benign prostatic hyperplasia, or BPH) that is causing urinary symptoms. TURP is a surgical procedure used to alleviate these symptoms by removing excess prostate tissue that is obstructing the urethra.

Preoperative Assessment:

Medical History Review: The patient's medical history, including any prior surgeries, allergies, medications, and underlying health conditions, is thoroughly reviewed.

Physical Examination: A physical examination is conducted to assess the patient's overall health and to evaluate the size and condition of the prostate gland.

Urological Evaluation: Urological assessments, including uroflowmetry and cystoscopy, may be performed to determine the degree of urinary obstruction and the appropriateness of the TURP procedure.

Medication Review: Medications that can affect bleeding, such as anticoagulants or antiplatelet drugs, may be adjusted or temporarily discontinued in consultation with the patient's healthcare team.

Anesthetic Management:

Anesthesia Choice: TURP can be performed under various types of anesthesia, including general anesthesia, spinal anesthesia, or epidural anesthesia. The choice depends on the patient's health, preferences, and the surgeon's recommendation.

Intravenous Fluids: Adequate intravenous fluids are administered to maintain hydration and ensure stable blood pressure during the procedure.

TURP Procedure:

Positioning: The patient is typically placed in a lithotomy position, similar to the position used for a pelvic exam. This position allows access to the urethra for the procedure.

Cystoscopy: A cystoscope, a thin tube with a camera on the end, is inserted into the urethra to visualize the prostate gland and assess the degree of obstruction.

Resection: Using a specialized instrument called a resectoscope, the surgeon removes excess prostate tissue by cauterizing it with an electric current. The tissue is then flushed into the bladder and later removed.

Irrigation: During the procedure, sterile fluid is continuously irrigated into the bladder to maintain visibility and help flush out tissue fragments.

Hemostasis: The surgeon ensures that any bleeding from the resected tissue is stopped by cauterization or other means.

Catheter Placement: A urinary catheter is often placed in the patient's bladder at the end of the procedure. This catheter helps drain urine and allows continuous bladder irrigation to remove any residual tissue and blood.