Management of Pain and Complications in Post-Operative Bladder Irrigation

Running head: CASE STUDY
CASE STUDY
Name of Student:
Name of University:
Author’s Note:

1CASE STUDY
Answer no 1.
Mr Brady who is 68 years old man was admitted to the hospital for transurethral prostate
resection surgery. Post-operation his pain was manageable was his health condition was in
control. However, as it was noted he was suffering from extreme bladder irrigation running with
pink tinged drainage. On evaluation, he compliant of 8/10 pain in the pelvic region which has got
increased over the time. The pain was making the patient discomfort and he was extreme
distress. Therefore, the priority action by the nurse would be to stopping the continuous bladder
irrigation and contacting the doctor (Sampson et al., 2019).
Answer no 2.
Transurethral resection of the prostate is the type of surgery which is used to treat and
remove the parts of grown prostate gland (Worthington et al., 2019). During the surgery, a
special instrument known as resectoscope used to remove any extra tissue blockage. In such
operation continuous bladder irrigation is used as the mean to manage the hemorrhage and
formation of clot after prostrate surgeries (Imlay et al., 2019). The patient has continuous balder
irrigation after the surgery. There is slight high probability in patient that he might develop clot
or may have problem of hemorrhage after the surgery. In order to avoid arising of such problems,
the patient was in continuous bladder irrigation. According to the Agrawal et al. (2018) the
patient who have undergone TRUP also experience interrupted drainage of urine and blood from
the lower urinary tract till the patient is in non-hemostasis state. Yoshida et al. (2019) said that
this causes continuous blockage of the catheter which is a great concern for the patient as well
the nurse. Hall and Rodgerson (2019) said that drainage of bladder post operation is mainly
effected through urethra, bladder and perineum. Thus, use of continuous irrigation of bladder

2CASE STUDY
with saline will help to remove any sort of blood blockage and will assist in attaining hemostasis
(Onishi et al., 2017). Continuous bladder irrigation given after the surgery is known to show
effectiveness which include preservation of the patency of the drainage catheter lumen, help to
prevent clot formation and its retention, helps in flushing of the clot when it becomes large in
size and helps to controlling bleeding.
Answer no 3.
The steps take would be taken as an intervention for management of pain:
 The nature of pain will be examined by determining the pain score.
 Nurse recognize those factors that might affect the patients’ expression of pain.
 Nurse on evaluation will determine the time to give pharmacological intervention to
manage the pain. If the pain is extreme, nurse would immediately administer analgesic in
consultation with the surgeon or health care professional (Chou et al., 2016).
 The dose of analgesic given should be calculated by the nurse to avoid any side effect of
the medicine.
 Nurse then evaluate the effectiveness of the analgesic (Kisely et al., 2015).
 Nurse will check the blockage of catheter time to time.
 Nurse will change the catheter after recognition of any blockage.
Answer no 4
Post-operative bladder irrigation is often regarded as the mean of preventing clot
formation and maintaining hemorrhage in patient who have undergone transurethral resection of
prostate. However, such method is connected with various complication which can lead to severe

3CASE STUDY
consequence of the patients. Three major complication of continuous bladder irrigation are as
follows:
Catheter blockage: Blockage of the catheter is the one of the major complication of the
continuous bladder irrigation. With continuous irrigation, there is flush of the clot which might
get formed after the operation. Those clot is responsible to cause blockage which does not allow
passage of urine from the bladder or caused retention of urine. The catheter blockage is evident
with the suprapubic distention which is associated with the discomfort in the lower abdomen.
The complication will cause no passage of urine which causes vaso-vagal symptoms like
sweating, hypotension, tachycardia and urgency (Avallone et al., 2017). If such complication
occurred then irrigation should be halted immediately in order to prevent filling of bladder and
discomfort in the patients. Manual bladder irrigation is the ultimate step to catheter is not able to
get unblock. More serious complication is retention of urine are organ damage and death
(Dungerwalla et al., 2015)
Discomfort during the procedure- Another complication linked with the continuous bladder
irrigation is connected with its procedure. During the process both male and female experience
uneasy with urinary catheter (Do et al., 2018).
Urinary tract infection: The tract infection is the other complication of the continuous bladder
irrigation which has led to increase in rate of morbidity, mortality and length of stay. Infection is
the most with the methods because catheters is known to inoculate the harmful organism into the
bladder. Such situation causes colonization of the bacteria or fungus as it provide a surface for its
growth causing mucosal irritation (Ding et al., 2016). It is known that urine is the house of
various germs and bacteria, with its continuous passage causes the risk of its growth and cause
urinary tract infection. Those bacteria quickly grows in colony making biofilms which has