Concept

Transurethral resection of the prostate

Transurethral resection of the prostate (commonly known as a TURP, plural TURPs, and rarely as a transurethral prostatic resection, TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. It has been the standard treatment for BPH for many years, but recently alternative, minimally invasive techniques have become available. This procedure is done with spinal or general anaesthetic. A triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete.The outcome is considered excellent for 80–90% of BPH patients. The procedure carries minimal risk for erectile dysfunction, moderate risk for bleeding, and a large risk for retrograde ejaculation. BPH is normally initially treated medically through alpha antagonists such as tamsulosin, or 5-alpha-reductase inhibitors such as finasteride and dutasteride. If medical treatment does not reduce a patient's urinary symptoms, a TURP may be considered following a careful examination of the prostate or bladder through a cystoscope. If TURP is contraindicated, a urologist may consider a simple prostatectomy, in and out catheters, or a supra-pubic catheter to help a patient void urine effectively. As the medical management of BPH improves, the number of TURPs have been decreasing. Traditionally, a cystoscope (a "resectoscope") has been used to perform TURP. The scope is passed through the urethra to the prostate where surrounding prostate tissue can then be excised. There are two types of modalities: Monopolar TURP: A monopolar device utilizing a wire loop with electric current flowing in one direction (thus monopolar) can be used to excise tissue via the resectoscope. A grounding ESU pad and irrigation by a non conducting fluid is required to prevent this current from disturbing surrounding tissues.

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Cours associés (1)
BIO-320: Morphology I
Ce cours est une préparation intensive à l'examen d'entrée en 3ème année de Médecine. Les matières enseignées sont la morphologie macroscopique (anatomie), microscopique (histologie) du corps humain.
Concepts associés (12)
5α-Reductase inhibitor
5α-Reductase inhibitors (5-ARIs), also known as dihydrotestosterone (DHT) blockers, are a class of medications with antiandrogenic effects which are used primarily in the treatment of enlarged prostate and scalp hair loss. They are also sometimes used to treat excess hair growth in women and as a component of hormone therapy for transgender women. These agents inhibit the enzyme 5α-reductase, which is involved in the metabolic transformations of a variety of endogenous steroids.
Dutastéride
Le dutastéride, vendu entre autres sous le nom de marque Avodart. Est un médicament principalement utilisé pour traiter les symptômes d'une hypertrophie de la prostate . Quelques mois peuvent être nécessaires avant que les bénéfices ne se manifestent. Il est également utilisé pour la perte de cheveux du cuir chevelu chez les hommes et dans le cadre de l'hormonothérapie chez les femmes transgenres . Il est pris par voie orale.
Symptômes du bas appareil urinaire
Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. The term is more commonly applied to men—over 40% of older men are affected—but lower urinary tract symptoms also affect women. The condition is also termed prostatism in men, but LUTS is preferred.
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