3-44. TRANSURETHRAL SURGERY
a. General. By means of a resectoscope passed into the bladder via the
urethra, piecemeal resection of the prostate gland and of tumors of the bladder and
bladder neck may be carried out, and bleeding vessels and tumors may be fulgurated.
b. Operative Procedure. See Figure 3-12.
(1) The resectoscope is assembled. The sheath is fitted with its obturator.
The electrode and telescope are attached to the working element. The irrigating system
is connected to the sheath. The lamp cord or fiberoptic bundle is fitted to the telescope.
The electrode is attached to the electrosurgical unit. The currents are adjusted as the
(2) The surgeon lubricates the sheath containing the obturator and inserts it
into the urethra and bladder. The obturator is removed, and the operating element is
introduced through the sheath.
(3) Viewing the anatomy through the telescope, the surgeon begins the
electro-dissection, alternately cutting and coagulating. The bladder is permitted to
drain--washing out blood tissue and clots--and refill at intervals. The operating element
may be removed and evacuating devices such as the Ellik applied, to flush out the
(4) When the stones are present, they are trapped or crushed with
dislodgers or lithotrites, and copious irrigations are done.
Figure 3-12. Transurethral resection of bladder tumor.