Urology - Explain the following terminologies and what equipment is required for each:(a) TURP - Trans-Urethral Resection of Prostate.

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UROLOGY

1. Explain the following terminologies and what equipment is required for each:

(a) TURP - Trans-Urethral Resection of Prostate.

TURP is the surgical procedure for patients suffering from enlargement of the

prostate, causing obstructive symptoms, leading to possible urine retention.

A Resectorscope is entered via the urethra to the prostate to remove lumps

found, using a diathermy loop, by burning it away. The scope has a camera

attached, so the procedure can be monitored to ensure correct positioning.

Equipment;

Olympus Cystoscopy tray,

Resectorscope tray,

Light lead,

12 degree Telescope,

Cystoscopy set,

Leggings,

Underbuttock drape,

Steri-drape,

Small towel,

Double giving set,

Camera drape,

Sucker tubing (fluid exit),

Instillagel/Aqua gel,

Swabs,

Betadine skin prep,

Double bowl liner,

Ellik evacuator,

Litre warm water,

3 litres Glycine,

Jug.

Post OP;

Instillagel,

Two way/three way catheter,

4 litre drainage bag,

Catheter introducer.

Potentially - Query need for post-op irrigation, 3 ltr bag Saline.

(b) BNI - Bladder Neck Incision.

This is for treatment of a bladder neck obstruction. An incision is made into

the neck of the bladder, again by diathermy, using a cystoscope to view the

bladder, and then the resectorscope to make the incision. Can relieve water

retention.

Equipment;

As above -  plus a Collins knife.

(c) TURT (TURBT) - Trans-Urethral Resection of Bladder Tumour.

Again a cystoscope is used to view the bladder. If a raised lesion is detected

the resectorscope is used to burn it away, using a diathermy loop, and a

rollerball for haemastasis.

Equipment;

As above (a)

(d) Cystoscopy/Cystodiathermy - A Cystoscope is used to examine the the

bladder, bladder neck, trigone, prostate, and posterior wall of the bladder,

using light and camera on a tower system and monitored on a screen. Irrigation

is used to keep a clear view and stop the urethral walls collapsing onto the

camera. Cystodiathermy - Ablation/Coagulation of a lump, using a button

electrode, via a cystoscope. Specimens are taken to ascertain if tumours found,

whether they are benign or malignant.

Equipment;

Skin prep,

Fenestrated draping,

Cystoscope Set,

Cystoscope tray,

12 degree OlympusTelescope, (30 degree Stortz)

(70 degree telescope available for different angled view of bladder if

required)

Light lead,

Cystodiathermy tray (diathermy lead, plus 3 sizes button electrodes),

Single giving set/sterile water.

(e) Urethroscopy - Examining the Urethra with a rigid telescope.

Equipment;

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As Cystoscopy equipment,

Urethrotomy tray,

Urethral dialators,

Double giving set,

Sterile water/3ltr Saline,

Guide wire (available)

(f) Urethroscopy/Urethrotomy - A Urethrotome is passed beyond the

Stricture to release and widen the Urethra.

Equipment;

As above (e).

(g) Lithopaxy - Removal of stones in the bladder. Optical Lithotrite is passed

through the Urethra, into the bladder, used to crush stones into small enough

peices to be washed out.

Lithotripsy - is when the stones are blasted by shock waves with a Lithotriter.

Equipment;

Stone punch,

Double bowl,

Ellik evacuator,

Stone forceps tray,

Lithoclast ...

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