Anaesthesia for urological surgery

Abstract

Anaesthesia is commonly used to facilitate urological procedures and many patients are elderly with multiple co-morbidities. Urological procedures range from minor day case to major surgery in which extensive resources are needed both intra- and postoperatively. For simple day case procedures like cystoscopy or ureteroscopy, general anaesthesia is most commonly used because it allows for early ambulation. Transurethral resection of the prostate (TURP) needs special attention. TURP syndrome due to excessive absorption of the irrigation fluid can be catastrophic if not managed early. Avoiding contributing factors and choosing regional anaesthesia which allows for early detection are key. Careful perioperative planning and risk stratification is important in major urological cancer surgery. Most of these procedures will require general anaesthesia (due to longer operative time and more extensive surgical trauma). Postoperative pain management in the form of epidural or patient controlled multimodal analgesia are essential. Postoperative high-dependency care is beneficial.