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Transurethral Resection of the Prostate (TURP) is a surgical procedure commonly used to treat benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged and causes urinary symptoms. Here is a detailed overview of the TURP procedure:

1. Patient Evaluation:

  • Before the procedure, the patient undergoes a thorough medical evaluation, including a physical examination, blood tests, and imaging studies.

  • The severity of symptoms, prostate size, and overall health of the patient are considered to determine the appropriateness of TURP.

2. Anesthesia:

  • TURP is typically performed under general or spinal anesthesia. The choice depends on the patient's health and the surgeon's preference.

3. Positioning:

  • The patient is positioned on the operating table, often lying on their back with legs elevated in stirrups.

4. Cystoscopy:

  • A cystoscope, a thin tube with a light and camera at its tip, is inserted into the urethra. This allows the surgeon to visualize the interior of the urethra and prostate.

5. Resection of Prostate Tissue:

  • A resectoscope, which is a specialized instrument with a wire loop or electrode, is then passed through the cystoscope into the prostate.

  • The surgeon uses the resectoscope to remove excess prostate tissue by cutting or vaporizing it. This helps to relieve the obstruction of the urethra caused by an enlarged prostate.

6. Irrigation:

  • Throughout the procedure, a sterile irrigation solution is continuously flushed through the resectoscope to clear blood and tissue fragments, maintain visibility, and prevent complications.

7. Tissue Removal and Pathology Examination:

  • The removed prostate tissue is often sent for pathology examination to ensure the absence of cancer or other abnormalities.

8. Hemostasis:

  • After resecting the desired amount of prostate tissue, the surgeon ensures hemostasis (control of bleeding) by cauterizing or coagulating blood vessels.

9. Catheter Placement:

  • A urinary catheter is typically inserted through the penis into the bladder to allow urine to drain and to help with the healing process.

10. Postoperative Care:

  • The patient is closely monitored in a recovery area.

  • Pain management, monitoring for complications, and ensuring proper urinary drainage are essential during the initial postoperative period.

11. Catheter Removal and Follow-up:

  • The urinary catheter is usually removed within a few days to a week after the surgery, depending on the patient's recovery.

  • Follow-up appointments are scheduled to monitor the patient's progress and address any concerns.

12. Potential Complications:

  • While TURP is generally considered safe, potential complications can include bleeding, infection, urinary incontinence, and retrograde ejaculation.

It's important to note that advances in technology and surgical techniques have led to variations of TURP, such as laser prostatectomy, which uses laser energy instead of electrical current for tissue removal. The specific details of the TURP procedure may vary based on the surgeon's experience and the patient's individual case.

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