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TECHNIQUE
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Courtesy of youtube: https://www.youtube.com/watch?v=R7lbGT7JeTg&index=3&list=PLiNyFfeNHBp3lxvkNKmTyvmwCRniufqca&spfreload=10
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Duffey B, Monga M. Principles of endoscopy. In: Campbell’s Urology 10 th ed. Philadelphia: WB Saunders Co., 192-203
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Vaskularisasi prostat
•A.Vesikalis inferior
•A.Pundenda interna
•A.Hemorrhoidalis

Vasa Bodenoch &

Flocks
Cabang dari
A.vesikalis
inferior
Plexus Santorini
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• PERDARAHAN (ARTERI, SINUS VENOSUS PERI PROSTIKA)
• SINDROMA TUR PROSTAT 2 %( MUAL, HIPERTENSI, BRADIKARDI, KESADARAN
MENURUN, KEJANG)

• PERFORASI (BULI, CAPSUL PROSTAT)

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• ISK SAMPAI SEPTIKEMIA (2,3%)
• CLOT RETENSI (3,3%)
• RETENSI URIN
• PERDARAHAN SEKUNDER
• INKONTINENSIA URINE
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 Do safely &
efficiently

Work in low pressure Systematic approach

Achieve good TUR-P
hemostasis
1.
2.
3.
Reasons for this triphasic procedure :
Phases 1 and 2 permit rapid tissue removal,
since the danger of accidental injury is slight.
The final phase 3 (close to veromontanum and
external sphincter) requires slow careful surgery
Cone excision
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Excavation of the capsule
Resect the lateral lobe in a curve
fashion according to prostatic
configuration

Do not resect the lateral lobe in a

straight line fashion
Small single Extended cutting
cut
Instrument control
during excavation
 Segmental
method

Tangential
method
Resecting Endovesical Lateral
Lobe
Resecting Endovesical Lateral
Lobe
Resection of apical
tissue
Appearance
BEFORE apical
resection

Appearance
AFTER apical
resection
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 The appearance of apical tissue

BLADDER EMPTY BLADDER FULL

Always asses bladder neck and apical tissue with the

bladder empty
The initial cut should be made with an empty bladder
The Wobble Test
Rectal palpation around the prostatic apex
Nesbit’s Method
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Nesbit’s Method
Nesbit’s Method
Barnes’
Method
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Alcock and Flocks Method
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Mauermayer Method
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