Counseling: TURP.
Hello Mr. Smith I am Dr. Munagapati, senior house officer in the department of Surgery. I understand that you have a problem when passing urine. Your stream is not very good. You have also said that you need to go very often to the toilet. We have examined you and found that your prostate is enlarged. As it is a benign enlargement, we would like you to undergo an operation called TURP, transurethral resection of the prostate.
This means that we will insert a small cystoscope through your urethra. The end of the cystoscope has a heated cutting loop with which we can remove all the abnormal tissue. The procedure will be done under general anesthesia. The anesthetist will come and have a word with you.
There are a few risks associated with this operation. There is a small chance that you may become infertile after the operation. You might notice some blood in your urine for the first 2 weeks.
After the operation, you should not drive for 2 weeks. You need to avoid sex for 2 weeks. Your ejaculate may be decreased and this is due to backward flow into the bladder. This can make the urine look cloudy. You might have to go to the toilet more frequently, but this should settle in a few weeks time.
Do you have any questions? Thank you Mr. Smith.
For carcinoma of the prostate: do PSA and serum alk phos to confirm metastatic Ca. Treatment options: Radiotherapy and analgesics for pain and Hormonal therapy with stilbesterol. If there is no metastasis prostatectomy and stilbesterol (orchidectomy can be an option).