TURP

経尿道的前立腺切除術

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/22 16:07:32」(JST)

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"Turp" redirects here. For the village in Iran, see Turp, Iran.

Transurethral resection of the prostate
Intervention
Micrograph of a transurethral resection of the prostate (TURP) specimen, showing BPH (nodular hyperplasia of the prostate) - left-of-center in image. H&E stain.
ICD-9-CM	60.29
MeSH	D020728
MedlinePlus	002996

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. This is considered the most effective treatment for BPH. 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. Outcome is considered excellent for 80-90% of BPH patients.

Indications

BPH is normally initially treated medically. This is done through alpha antagonists such as Flomax or 5-alpha-reductase inhibitors such as Proscar and Avodart. If medical treatment does not reduce a patient's urinary symptoms, a TURP may be considered following a careful examination of the prostate/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 medical management of BPH improves, the numbers of TURPs have been decreasing.

Types of TURP

See also: Prostatectomy#Transurethral_resection_of_the_prostate_(TURP)

Risks

Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems.

Postoperative complications include

• Bleeding (most common). Bleeding may be reduced by pre-treatment with an anti-androgen such as finasteride or flutamide.^{[citation needed]}
• Clot retention and clot colic
• Bladder wall injury such as perforation (rare)
• TURP Syndrome: Hyponatremia and water intoxication (symptoms resembling brain stroke in an elderly presenting patient) caused by an overload of fluid absorption (e.g. 3 to 4 Litres) from the open prostatic sinusiods during the procedure. This complication can lead to confusion, changes in mental status, vomiting, nausea, and even coma. To prevent TURP syndrome the 1) length of the procedure is limited to less than one hour in many centers, and 2) the height of the container of irrigating solution above the surgical table determining the hydrostatic pressure driving fluid into the prostatic veins and sinuses is kept to a minimum.
• Bladder neck stenosis
• Urinary incontinence due to injury of external sphincter system which may be prevented by taking the Verumontanum of the prostate as a distal limiting boundary during TURP
• Retrograde ejaculation due to injury of preprostatic (internal) sphincter system

Additionally, transurethral resection of the prostate is associated with a low risk of mortality.

See also

• Transurethral needle ablation of the prostate
• Transurethral incision of the prostate
• Prostatectomy, describes monopolar and bipolar [electrocautery] TURP
• Prostatic stent

References

External links

• Medscape: Transurethral Resection of the Prostate

UpToDate Contents

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• 1. 良性前立腺肥大症の経尿道的手技による治療 transurethral procedures for treating benign prostatic hyperplasia
• 2. 経尿道的切除術またはヒステロスコピー後の低ナトリウム血症 hyponatremia following transurethral resection or hysteroscopy
• 3. 前立腺生検 prostate biopsy
• 4. 急性尿閉 acute urinary retention
• 5. 男性の尿失禁 urinary incontinence in men

English Journal

• Effects of four different cooking methods on some quality characteristics of low fat Inegol meatball enriched with flaxseed flour.

• Turp GY1.
• Meat science.Meat Sci.2016 Nov;121:40-6. doi: 10.1016/j.meatsci.2016.05.016. Epub 2016 May 25.
• The present study is concerned with the effects of four different cooking methods (grill, oven, pan and ohmic cooking) on physicochemical parameters (cooking yield moisture retention, fat retention, color, texture), fatty acid composition and sensory characteristics of low fat Turkish traditional In
• PMID 27258146

• Evaluation of the ProPublica Surgeon Scorecard "Adjusted Complication Rate" Measure Specifications.

• Ban KA1, Cohen ME, Ko CY, Friedberg MW, Stulberg JJ, Zhou L, Hall BL, Hoyt DB, Bilimoria KY.
• Annals of surgery.Ann Surg.2016 Oct;264(4):566-74. doi: 10.1097/SLA.0000000000001858.
• OBJECTIVES: The ProPublica Surgeon Scorecard is the first nationwide, multispecialty public reporting of individual surgeon outcomes. However, ProPublica's use of a previously undescribed outcome measure (composite of in-hospital mortality or 30-day related readmission) and inclusion of only inpatie
• PMID 27433895

• The Urolift System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A NICE Medical Technology Guidance.

• Ray A1, Morgan H2, Wilkes A3, Carter K4, Carolan-Rees G3.
• Applied health economics and health policy.Appl Health Econ Health Policy.2016 Oct;14(5):515-26. doi: 10.1007/s40258-015-0218-x.
• As part of its Medical Technologies Evaluation Programme (MTEP), the National Institute for Health and Care Excellence (NICE) invited Neotract (manufacturer) to submit clinical and economic evidence for their prostatic urethral lift device, Urolift, for the relief of lower urinary tract symptoms sec
• PMID 26832146

Japanese Journal

• TURP上達のコツと周術期トラブル症例の実例と対応 (特集 前立腺肥大症手術のコツとトラブルシューティング)

• Prostate journal 2(2), 249-253, 2015-10
• NAID 40020645600

• 高齢者の前立腺肥大症に対する外科的治療法：PVP と HoLEP

• 日本レーザー医学会誌 35(4), 445-450, 2015
• NAID 130005152328

• Anteroposterior HoLEP法に基づいた教育によるHoLEP習得のラーニングカーブの検討

• Japanese Journal of Endourology 28(1), 142-146, 2015
• NAID 130005073697

Related Links

• TURPとは｜TURP(経尿道的前立腺全切除術）日帰り手術 ...

新都心クリニックでは、手術後3時間後にはホテルにてくつろぐ事ができるTURP手術を行っております。（一般の平均入院日数は7～10日間） 翌日には帰宅できるため、全国から多くの患者さんが手術を受けに来ておられます。

• 前立腺肥大症の代表的手術法『TURP』とは？ ：前立腺肥大症 ...

前立腺肥大症の代表的手術法『TURP』とは？ 前立腺肥大症の手術で最もよく利用されるのがTURPといわれる手術方法です。TURPとは経尿道的前立腺切除術といわれるもので、尿道から内視鏡を挿入し、内視鏡で前立腺の患部を観察 ...

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リンク元	「経尿道的前立腺摘除術」
関連記事	「TU」

「経尿道的前立腺摘除術」

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英

transurethral prostatectomy　(一体どういう使い分け？)

同

(国試)経尿道的前立腺切除術(国試的にはこちらの用語), transurethral resection of prostate, TURP

関

前立腺、前立腺肥大症。経尿道的前立腺摘除

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• 小さい前立腺肥大症で適応となる。大きければ、より侵襲の大きい前立腺被膜下摘除術の適応。

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