01/06/24 TURP 52601
01/09/24 Looking for some help with this one (This was not a planned/staged procedure):
The patient is a 77-year-old male with prostate cancer and urinary retention requiring and indwelling foley catheter. He is status post a channeling TURP on 1/7/25 but had persistent gross hematuria with a drop in his Hgb. The options for treatment were discussed with the patient in detail and he wished to proceed with surgical intervention namely cystoscopy with transurethral resection of the prostate. The risks and benefits of the procedure were discussed with the patient in detail with the risks including, but not limited to, bleeding, infection, pain, scarring, damage to surrounding structures, urinary incontinence, TUR syndrome, deep vein thrombosis, pulmonary embolus, myocardial infarction and death. Patient understood the risks and was willing to proceed.
After a detailed informed consent was obtained, the patient was taken to the Operating Room and placed in the lithotomy position. After general anesthesia was established, he was then placed in the lithotomy position. The area of the genitalia was then prepped and draped in the usual sterile fashion. Initially a #22 Fr rigid cystoscope was then advanced into the bladder. The bladder was completely inspected. Once this was completed the rigid cystoscope was removed.
The 27 Fr resectoscope sheath with visual obturator was advanced into the bladder. The bipolar, Olympus ESG-400 electrosurgical generator was utilized with cut set at 200 watts and coagulation at 120 watts. The loop working element and the button element were utilized to obtain hemostasis in the prostatic fossa and the left side of the bladder neck. The button element was utilized to vaporize additional tissue. The verumontanum as well as bilateral ureteral orifices were identified and preserved. A 20 Fr 3-way hematuria foley catheter was then inserted into the bladder. 40 ml of water placed into the balloon. The foley was then hand-irrigated and the urine was noted to be clear. The patient was awakened from anesthesia *** and placed back in the supine position. At this point the operation was complete.
Thank you for any help you may be able to give.
01/09/24 Looking for some help with this one (This was not a planned/staged procedure):
The patient is a 77-year-old male with prostate cancer and urinary retention requiring and indwelling foley catheter. He is status post a channeling TURP on 1/7/25 but had persistent gross hematuria with a drop in his Hgb. The options for treatment were discussed with the patient in detail and he wished to proceed with surgical intervention namely cystoscopy with transurethral resection of the prostate. The risks and benefits of the procedure were discussed with the patient in detail with the risks including, but not limited to, bleeding, infection, pain, scarring, damage to surrounding structures, urinary incontinence, TUR syndrome, deep vein thrombosis, pulmonary embolus, myocardial infarction and death. Patient understood the risks and was willing to proceed.
After a detailed informed consent was obtained, the patient was taken to the Operating Room and placed in the lithotomy position. After general anesthesia was established, he was then placed in the lithotomy position. The area of the genitalia was then prepped and draped in the usual sterile fashion. Initially a #22 Fr rigid cystoscope was then advanced into the bladder. The bladder was completely inspected. Once this was completed the rigid cystoscope was removed.
The 27 Fr resectoscope sheath with visual obturator was advanced into the bladder. The bipolar, Olympus ESG-400 electrosurgical generator was utilized with cut set at 200 watts and coagulation at 120 watts. The loop working element and the button element were utilized to obtain hemostasis in the prostatic fossa and the left side of the bladder neck. The button element was utilized to vaporize additional tissue. The verumontanum as well as bilateral ureteral orifices were identified and preserved. A 20 Fr 3-way hematuria foley catheter was then inserted into the bladder. 40 ml of water placed into the balloon. The foley was then hand-irrigated and the urine was noted to be clear. The patient was awakened from anesthesia *** and placed back in the supine position. At this point the operation was complete.
Thank you for any help you may be able to give.