TURP info needed

[AlabamaBelle]

To all you wonderful adult med/surg RNs

Okay...so I'm a Peds ICU RN. My husband will be having a TURP in the next 2 weeks. What I remember from school is a bet sketchy. Could y'all refresh my memory about what to expect. As I tell my family, I do kids, not adults, if it isn't a kiddie problem, I don't do it!!! I can't find my notes from school or my med-surg book.

And may I say I'm not looking forward to this - whiny adult males drive me batty! And he is a bit wimpy about pain.

I appreciate any and all responses to fill in this "gap".

Thanks,

Cindy, RN

[GrumpyRN63, ADN, RN]

Not my forte either, all I remember is continuous bladder irrigation w/bloody urine w/clots, pain, esp if the cath gets occluded w/ the clots, sorry to hear, I wish you both the best

[nici1978]

usually your husband stays in the hospital for 1 or 2 nights,

turp = transurethal prostatectomy, expect after surgery continuos bladderirrigation for at least one night, most patients have not a lot of pain, they get suppository containing opiates to ease bladder spasm, next day ( 1. post op day) usually the irrigation gets titrated until stopped, ( 2. day post op) discontinue foley and do frequent bladder ultrasounds to see if the patient can void ok, than mostly patient gets discharged the same day,

most of my patients did not make a big deal out of it,

just watch for large amounts of blood in urine at home

nici

[lsyorke, RN]

usually your husband stays in the hospital for 1 or 2 nights,

turp = transurethal prostatectomy, expect after surgery continuos bladderirrigation for at least one night, most patients have not a lot of pain, they get suppository containing opiates to ease bladder spasm, next day ( 1. post op day) usually the irrigation gets titrated until stopped, ( 2. day post op) discontinue foley and do frequent bladder ultrasounds to see if the patient can void ok, than mostly patient gets discharged the same day,

most of my patients did not make a big deal out of it,

just watch for large amounts of blood in urine at home

nici

And make sure there's a toomey at the bedside for any nasty clots!

[nici1978]

second the toomey

[chenoaspirit, ASN, RN]

usually your husband stays in the hospital for 1 or 2 nights,

turp = transurethal prostatectomy, expect after surgery continuos bladderirrigation for at least one night, most patients have not a lot of pain, they get suppository containing opiates to ease bladder spasm, next day ( 1. post op day) usually the irrigation gets titrated until stopped, ( 2. day post op) discontinue foley and do frequent bladder ultrasounds to see if the patient can void ok, than mostly patient gets discharged the same day,

most of my patients did not make a big deal out of it,

just watch for large amounts of blood in urine at home

nici

They also give oral meds to ease the bladder spasms (cant remember the name of it) and IV narcotics for pain. We also give B&O suppositories (Belladonna and Opium). They have a continuous bladder irrigation that is slowed down when the urine is clear, and turned up faster if it gets bloody to prevent clots. The catheter is larger than a regular foley and is irrigated when clots form that stop it up. It's normally d/ced within a couple days of surgery (longer if the prostate is unusually large). Patients usually do fine with the surgery. My dad has to have it too.

[Piki]

Levsin is the PO med given. I took care of a few TURPs over the past few weeks. Actually compared to other surgeries, this recovery is not bad at all and I really can't recall any whiny male TURP pts. Hand irrigation for clots can be a bit painful, so it may be in your husband's best interest to have something beforehand for pain if that's necessary.

Honestly the docs that do the TURPs generally dont' like to medicate with narcotics for post op -- we see alot of orders for celebrex and/or tylenol (round the clock) with the option of the suppositories and levsin, and the patients do fine. Some go home on the leg bags, some docs have the foley removed prior to them going home.

Good luck to your DH.

[Diana,RN]

and here's the foreigner asking: What the heck is a "toomey?"

Diana

[AlabamaBelle]

Thank you guys so much! I appreciate the info. I just need to know what to expect. Even though I work at a good facility, I'm still very nervous about this hospitalization. If I can allay his fears as to what is normal/expected, may be I can decrease his anxiety and ultimately benefit myself (decreased anxiety = decreased pain).

THANKS!!!!!

Cindy, RN

[SDS_RN, RN]

usually your husband stays in the hospital for 1 or 2 nights,

turp = transurethal prostatectomy, expect after surgery continuos bladderirrigation for at least one night, most patients have not a lot of pain, they get suppository containing opiates to ease bladder spasm, next day ( 1. post op day) usually the irrigation gets titrated until stopped, ( 2. day post op) discontinue foley and do frequent bladder ultrasounds to see if the patient can void ok, than mostly patient gets discharged the same day,

most of my patients did not make a big deal out of it,

just watch for large amounts of blood in urine at home

This post is exactly what we do in our facility also. However, we use Probanthine for bladder spasms not suppositories unless the pain is unrelieved by the Probanthine. Most of our TURPs have done really well w/ minimal pain or discomfort. Good luck to your husband.

[august07]

TURP stands for transurethral resection of the prostate. Correct me if I'm wrong but I think they don't remove the entire prostate, just part of it so it's not really a prostatectomy.--------------------------------------------------------------------------------and here's the foreigner asking: What the heck is a "toomey?"Toomey's are those big plastic syringes that hold 70ml of fluid. We use them not only for catheter irrigation, but also PEG tube feedings and NG tube irrigations. You must call them by another name.

[Diana,RN]

Thanks, I call them Piston syringe or Bulb syringe. Haven't heard the term Toomey before.