Special Surgical Procedures II LESSON 3: Procedures in Genitourinary Surgery Section Iv: operations on the bladder and prostate
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3-30. PERINEAL PROSTATECTOMY
a. General. Either enucleation of adenomas or radical prostatectomy may be carried out through a perineal exposure.
b. Patient Preparation. The patient is placed on the operating table in an extreme lithotomy position. The buttocks are elevated on pads sufficient to tilt the pelvis and flatten the perineum on the vertical plane. The thighs are fully flexed with the knees to the chest and the feet are supported in stirrups. The arms are extended on armboards and shoulder braces applied with the usual precautions. Measures must be taken to reduce strain on the muscles and nerves of the back and legs and also prevent respiratory embarrassment from compression of the abdomen and chest. Draping is with an O'Connor drape and perineal sheet.
c. Operative Procedure.
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