A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the nurse is aware that the functions of the three lumens include:
a- Continuous inflow and outflow of irrigation solution.
b-Intermittent inflow and continuous outflow of irrigation solution.
c- Continuous inflow and intermittent outflow of irrigation solution.
d- Intermittent flow of irrigation solution and prevention of hemorrhage.
Answer A.
When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.
Transurethral resection of the prostate is a surgery used to treat urinary problems due to an enlarged prostate.
A combined instrument that is visual and surgical (resectoscope) is inserted through the tip of the penis and into the duct that carries urine from the bladder (urethra). The prostate surrounds the urethra. Using the resectoscope, the doctor trims the excess prostate tissue that blocks the flow of urine.
In general, transurethral resection of the prostate is considered an option for men with moderate to severe urinary problems who do not respond to medication. Traditionally, it is considered that transurethral resection of the prostate is the most effective treatment for enlarging the prostate.
However, thanks to improved surgical techniques and instruments, many other minimally invasive procedures become increasingly effective. In general, these minimally invasive procedures cause fewer complications and have a faster recovery period than transurethral resection of the prostate. The risk of bleeding is generally higher in transurethral resection of the prostate, so it may not be the best option for men taking anticoagulant medications.
Why it is done:
Transurethral resection of the prostate helps to reduce the urinary symptoms caused by benign prostatic hyperplasia, including:
- Frequent and urgent need to urinate
- Difficulty starting to urinate
- Slow urine (prolonged)
- Urinating more often during the night
- Stop and start urinating again
- Feeling of not being able to empty the bladder completely
- Urinary infections
Transurethral resection of the prostate can also be performed to treat or prevent complications due to blocked urine flow, such as:
- Recurrent urinary infections
- Kidney or bladder injury
- Inability to control urination or total inability to urinate
- Bladder stones
- Blood in the urine
Risks:
The risks of transurethral resection of the prostate may include:
- Difficulty urinating temporarily:
You may have trouble urinating for a few days after the procedure. Until you can urinate on your own, you will need to have a catheter inserted into the penis to expel urine from the bladder.
- Urinary infection:
This type of infection is a possible complication after any prostate procedure. The longer you have the catheter in place, the more likely it is that an infection will occur. Some men who undergo a transurethral resection of the prostate have recurrent urinary tract infections.
- Dry orgasm:
A frequent and long-term effect of any type of prostate surgery is the release of semen into the bladder, rather than through the penis, during ejaculation. Dry orgasm, also known as "retrograde ejaculation," is not painful and usually does not affect sexual pleasure. However, it can interfere with your ability to father a child.
- Erectile dysfunction:
Although the risk is very low, an erectile dysfunction may occur after prostate treatments.
- Intense bleeding:
In exceptional cases, men lose so much blood during transurethral resection of the prostate that they need a blood transfusion. Men who have larger prostates seem to be more prone to significant blood loss.
- Difficulty in containing urine:
Loss of bladder control (incontinence) is a rare long-term complication of transurethral resection of the prostate.
- Low blood sodium level. Rarely, the body absorbs too much of the fluid that is used to wash the area of the surgery during transurethral resection of the prostate. This disorder, known as "transurethral resection syndrome of the prostate" or "transurethral resection syndrome," is potentially fatal if left untreated. A technique called "bipolar transurethral resection of the prostate" eliminates the risk of suffering the syndrome of transurethral resection of the prostate.
- Need to redo the treatment. Some men may need follow-up treatment after transurethral resection of the prostate because the symptoms reappear over time or never improve adequately. Sometimes, it is necessary to repeat the treatment because the transurethral resection of the prostate causes a narrowing (constriction) of the urethra or neck of the bladder.
a- Continuous inflow and outflow of irrigation solution.
b-Intermittent inflow and continuous outflow of irrigation solution.
c- Continuous inflow and intermittent outflow of irrigation solution.
d- Intermittent flow of irrigation solution and prevention of hemorrhage.
Answer A.
When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.
Transurethral resection of the prostate is a surgery used to treat urinary problems due to an enlarged prostate.
A combined instrument that is visual and surgical (resectoscope) is inserted through the tip of the penis and into the duct that carries urine from the bladder (urethra). The prostate surrounds the urethra. Using the resectoscope, the doctor trims the excess prostate tissue that blocks the flow of urine.
In general, transurethral resection of the prostate is considered an option for men with moderate to severe urinary problems who do not respond to medication. Traditionally, it is considered that transurethral resection of the prostate is the most effective treatment for enlarging the prostate.
However, thanks to improved surgical techniques and instruments, many other minimally invasive procedures become increasingly effective. In general, these minimally invasive procedures cause fewer complications and have a faster recovery period than transurethral resection of the prostate. The risk of bleeding is generally higher in transurethral resection of the prostate, so it may not be the best option for men taking anticoagulant medications.
Why it is done:
Transurethral resection of the prostate helps to reduce the urinary symptoms caused by benign prostatic hyperplasia, including:
- Frequent and urgent need to urinate
- Difficulty starting to urinate
- Slow urine (prolonged)
- Urinating more often during the night
- Stop and start urinating again
- Feeling of not being able to empty the bladder completely
- Urinary infections
Transurethral resection of the prostate can also be performed to treat or prevent complications due to blocked urine flow, such as:
- Recurrent urinary infections
- Kidney or bladder injury
- Inability to control urination or total inability to urinate
- Bladder stones
- Blood in the urine
Risks:
The risks of transurethral resection of the prostate may include:
- Difficulty urinating temporarily:
You may have trouble urinating for a few days after the procedure. Until you can urinate on your own, you will need to have a catheter inserted into the penis to expel urine from the bladder.
- Urinary infection:
This type of infection is a possible complication after any prostate procedure. The longer you have the catheter in place, the more likely it is that an infection will occur. Some men who undergo a transurethral resection of the prostate have recurrent urinary tract infections.
- Dry orgasm:
A frequent and long-term effect of any type of prostate surgery is the release of semen into the bladder, rather than through the penis, during ejaculation. Dry orgasm, also known as "retrograde ejaculation," is not painful and usually does not affect sexual pleasure. However, it can interfere with your ability to father a child.
- Erectile dysfunction:
Although the risk is very low, an erectile dysfunction may occur after prostate treatments.
- Intense bleeding:
In exceptional cases, men lose so much blood during transurethral resection of the prostate that they need a blood transfusion. Men who have larger prostates seem to be more prone to significant blood loss.
- Difficulty in containing urine:
Loss of bladder control (incontinence) is a rare long-term complication of transurethral resection of the prostate.
- Low blood sodium level. Rarely, the body absorbs too much of the fluid that is used to wash the area of the surgery during transurethral resection of the prostate. This disorder, known as "transurethral resection syndrome of the prostate" or "transurethral resection syndrome," is potentially fatal if left untreated. A technique called "bipolar transurethral resection of the prostate" eliminates the risk of suffering the syndrome of transurethral resection of the prostate.
- Need to redo the treatment. Some men may need follow-up treatment after transurethral resection of the prostate because the symptoms reappear over time or never improve adequately. Sometimes, it is necessary to repeat the treatment because the transurethral resection of the prostate causes a narrowing (constriction) of the urethra or neck of the bladder.
How do you prepare:
Food and medications:
Several days before surgery, the doctor may recommend that you stop those medications that increase the risk of bleeding, including:
- Anticoagulants such as warfarin (Coumadin) or clopidogrel (Plavix)
- Over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB and others) or naproxen sodium (Aleve and others)
You may be prescribed an antibiotic to prevent urinary tract infections.
Other precautions:
Organize the transport, because that day you will not be able to drive back home after the procedure or, in general, the same happens if you have a bladder catheter.
You may not be able to work or do strenuous activities for up to six weeks after surgery. Ask the doctor how much recovery time you might need.
What you can expect:
Transurethral resection of the prostate usually lasts 60 to 90 minutes. Before surgery you will be given general anesthesia, which means you will be unconscious during the procedure, or intradural anesthesia, which means you will remain conscious. You may also receive a dose of antibiotics to prevent infections.
During the procedure:
The resectoscope is inserted into the tip of the penis and passed through the urethra to the prostate. The doctor will not have to make any cuts (incisions) on the outside of the body.
The doctor will use the resectoscope to cut the tissue inside the prostate from a small section at a time. As the small sections of tissue inside the prostate are cut, the irrigated fluid carries them to the bladder. These are eliminated at the end of the operation.
After the procedure:
You are likely to stay in the hospital for a day or two.
You will have a urinary catheter placed, since the passage of urine is blocked by the swelling. Generally, the catheter is left for at least 24 to 48 hours, until the swelling subsides and you can urinate on your own.
You may also notice:
- Blood in the urine:
It is normal to see blood immediately after surgery. But if the blood in the urine is thick like ketchup, the bleeding seems to get worse or the flow of urine is blocked, contact the doctor. Blood clots can block the flow of urine.
- Irritant urinary symptoms:
You may feel pain when you urinate or have a sense of urgency or frequent need to urinate. Generally, pain during urination is relieved between six and eight weeks.
The doctor may recommend that you:
-You drink a lot of water to clean the bladder.
-You eat foods rich in fiber, to avoid constipation and effort during a bowel movement. The doctor may also recommend a stool softener.
- Wait to take any anticoagulant medication again until the doctor allows it.
- Avoid strenuous activities, such as lifting heavy loads, for four to six weeks or until the doctor allows it.
- Refrain from having sex for four to six weeks.
- Avoid driving until the catheter is removed and you no longer take the prescribed analgesics.
Contact your doctor if:
- You can not pee.
- You see bright red blood or an increase in clots in the urine that do not go away after drinking more fluid and resting for 24 hours.
- Having more than 100.4 ° F (38 ° C) of fever.
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Genitourinary