Most common type of surgery for BPH?

NHM UP Staff Nurse - 2016

Medical & Surgical Nursing

Easy

Appeared in: NHM UP Staff Nurse - 2016

Explanation

Transurethral Resection of the Prostate (TURP) is the most frequently performed surgery for BPH and is considered the benchmark against which other treatments are measured.
The procedure is endoscopic, meaning it is performed by passing a resectoscope through the urethra, thus avoiding an external skin incision.
This minimally invasive approach results in quicker symptom relief, a shorter hospital stay, and a faster recovery period compared to open surgical methods.

Option A: Suprapubic prostatectomy is an open surgery that requires an incision into the bladder. It is more invasive and has a longer recovery time than TURP.
Option B: The perineal approach is very rarely used for BPH due to a higher risk of complications, particularly erectile dysfunction.
Option D: Retropubic prostatectomy is an open surgical procedure and is therefore more invasive and less common than TURP.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical management of Benign Prostatic Hyperplasia (BPH) as background academic context rather than a clinical decision trigger.
A key nursing priority after TURP is managing the Continuous Bladder Irrigation (CBI) system to prevent catheter obstruction from blood clots. The nurse must titrate the irrigation flow to keep the urine light pink and ensure the output is greater than the input.
Nurses must be vigilant in monitoring for TURP syndrome, a potentially life-threatening complication from absorbing excess irrigation fluid. Key signs include confusion, nausea, hypertension, bradycardia, and visual disturbances. Prompt recognition and reporting are crucial.
What if the patient's prostate is extremely large (greater than 100 grams)? In this scenario, TURP may be less effective or take too long, increasing risks. An open procedure like a suprapubic or retropubic prostatectomy would likely be the preferred surgical approach.

How to Approach the Question

First, identify the key terms in the question: 'Most common', 'surgery', and 'BPH'. This directs you to find the standard, most frequently used surgical intervention for this specific condition.
This is a factual recall question. Access your knowledge about urological procedures.
Mentally categorize the options. 'Transurethral resection' is an endoscopic (minimally invasive) procedure. The other three (Suprapubic, Perineal, Retropubic) are types of open prostatectomy.
Recall the general principle in modern surgery that minimally invasive techniques are preferred whenever possible due to lower morbidity and faster recovery.
Based on this principle, deduce that the transurethral approach is likely the most common for a condition as prevalent as BPH.
Confirm that TURP is indeed the gold standard treatment, while open surgeries are reserved for specific, less common situations like very large prostates.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 458-460