Prostate Percy — BPH & TURP Care
Bright red urine with clots post-TURP is expected briefly — watch for bladder spasms and clot retention
Percy has struggled for months with a weak urine stream and getting up three times a night to void, so his TURP finally seemed like relief. Now, hours after surgery, his bladder feels tight and painful, and the drainage bag has stopped filling despite his irrigation running wide open.
Percy's benign prostatic hyperplasia enlarges his prostate gland, compressing the urethra and causing hesitancy, weak stream, nocturia and incomplete bladder emptying. After a transurethral resection of the prostate (TURP), he returns with continuous bladder irrigation (CBI) through a three-way catheter to prevent clot formation and obstruction. Expected urine is light pink to red for the first day, but bright red urine with large clots, rising bladder distention, or severe suffocating bladder spasms signal a complication requiring rapid intervention.
Read Prostate Percy's full story →The story arc
The setup
Percy, 72, has BPH with urinary hesitancy, weak stream, nocturia and a sensation of incomplete emptying, prompting a TURP procedure.
The turn
Post-op, Percy has a three-way indwelling catheter with continuous bladder irrigation, and his urine is light pink as expected.
The crisis
Percy suddenly reports severe suprapubic pain and an urge to void, the irrigation fluid is running in but not draining out, and his bladder is visibly distended and bright red with clots.
The save
The nurse stops or slows irrigation, checks catheter tubing for kinks, manually irrigates with a piston syringe per protocol to dislodge the clot, and notifies the provider if patency cannot be restored.
NCLEX study section — BPH & TURP Care
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Gastrointestinal & Renal
Take this chapter into practice questions on the same topic.