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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. ...read more.


As long as the surgery is taking place and instruments are being used, the area is being irrigated to reduce the risk of trauma to tissue and keep a clear view of the operatie site. A large bag of saline is connected and pumped through tubing, until the surgeon is satisfied that the operation is complete. A closed system is used, involving a Cystoscope and giving set. It reduces clot retention, and discomfort of a distended bladder, and reduces the risk of the catheter being blocked. (c)What are the advantages of this whilst using a resectoscope? Its acts as a coolant to reduce unneccessary burning, and gives the surgeon a clear view. 4. Telescopes: (a) Describe the maintenance, cleaning and sterilization of telescopes prior to use. Cleaning -Disassemble the instrumentation. Immerse in warm soapy water and ensure all surfaces are cleaned. A cotton bud may assist to access the distal lens, objective window and light guide post. If these area's are not thoroughly cleaned, the resulting image and illumination could be impaired. Where applicable, remove the eyepeice cap and gently brush the screw threads to remove any residual fluid or debris. ...read more.


The arm is supported, raised up to protect the axilliary nerve, and the other arm is placed so it is not being squased into the side of the patient. Abdomen and lumbar supports are used, attached to the table, and all area's are padded to protect from diathermy burns. Towards the end of surgery, the table is straightened at the surgeons command, to sew up the incision, so the skin is not stretched at this point. Some surgeons may perform this operation in the supine position, with a sandbag used to elevate the hips. D and E - Placed in the lithotomy position. Legs raised together to reduce the risk of dislocation, muscle and nerve damage. Arms folded and placed on chest. Pressure points are cushioned where required. G - Patient placed in Supine Jacknife position to give optimum access to the bladder. Pelvis is placed in line with an O mark on the table. As with all of the above padding is used to protect skin from diathermy burns and pressure points are considered. 9. What methods may be used to minimize heat loss during these procedures- include TURP. Fluid warmer Baer Hugger (warming blanket) Heated Operating theatre Warmed fluid (TURP, TURBT) ...read more.

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