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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. [3]
Following the procedure, the prostatic tissue will be swollen and irritated. Urologists often place a Foley catheter to prevent the patient from having urinary retention. After three to five days the Foley catheter can be replaced by a temporary prostatic stent to improve voiding without exacerbating irritation symptoms. [3]
When a Foley catheter becomes clogged, it must be flushed or replaced. There is currently not enough adequate evidence to conclude whether washouts are beneficial or harmful. [13] There are several risks in using a Foley catheter (or catheters generally), including: The balloon can break as the healthcare provider inserts the catheter.
Transurethral resection of the prostate (TURP) syndrome is a rare but potentially life-threatening complication of a transurethral resection of the prostate procedure. It occurs as a consequence of the absorption of the fluids used to irrigate the bladder during the operation into the prostatic venous sinuses. [ 1 ]
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Diagram of a Foley catheter. Foley first described the use of a self-retaining balloon catheter in 1929, to be used to achieve hemostasis after cystoscopic prostatectomy. [2] He worked on development of this design for use as an indwelling urinary catheter, to provide continuous drainage of the bladder, in the 1930s.
However, after this endoscopic surgery the ejaculations are dry in about 65% of patients, unless a novel, ejaculation preserving, altered technique of TURP is applied. [1] [2] Simple prostatectomy can also be offered to men who have large prostates (>50 grams). This can be done by open technique, laparoscopically, or with robotic assistance. [3]
They can be placed in less than 15 minutes in a manner similar to Foley catheter placement. They can be easily removed, also in a manner similar to Foley catheter removal. They allow the patient to retain volitional voiding. Some patients prefer a temporary stent to Foley catheter use.