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  • Chapter 28 - Anaesthesia for Urological Surgery

  • from Section 3 - Passing the Gas
  • William Fawcett, Royal Surrey County Hospital, Guildford and University of Surrey, Olivia Dow, Guy's and St Thomas' NHS Foundation Trust, London, Judith Dinsmore, St George's Hospital, London
  • Book:
    Robinson and Hall's How to Survive in Anaesthesia
    Published online:
    09 June 2025
    Print publication:
    26 June 2025, pp 159-165

  • Summary

    These procedures include diagnostic cystoscopies, the treatment of tumours in the urogenital tract (kidney, ureters, bladder and prostate) and treatment of urinary calculi. The majority of major urological surgery is performed with minimally invasive surgery, either from cystoscopes/resectoscopes (bladder and benign prostatic surgery) or via laparoscopic /robotic route (such as for malignancies of the kidney, bladder and prostate).

    A common operation is for benign prostatic hyperplasia and often involves transurethral resection of the prostate (TURP). This can be performed under regional (spinal) anaesthesia or general anaesthesia. Major problems can occur from blood loss and absorption of irrigating fluids (the latter referred to as TURP syndrome). This may require intensive care treatment with diuresis, correction of electrolyte abnormalities, circulatory support and even postoperative ventilation.

    Many patients are elderly and have significant comorbidities. In addition, patients are at risk of bleeding, urosepsis and impairment of renal function perioperatively.