Anesthesiology pp 741-753 | Cite as

Anesthesia for Urological Procedures

  • Hussam Ghabra
  • Susan A. SmithEmail author


Urologic procedures represent a substantial number of surgical cases occurring in both ambulatory surgery centers and inpatient hospitals. A considerable number of urologic surgery patients are elderly and suffer a wide range of comorbidities that require preoperative evaluation and medical optimization. Urologic procedures can be divided into endoscopy (endourologic) and major abdominal surgery. Endourologic procedures represent a sizeable volume of urologic surgery and can generally be performed on an outpatient basis. Common endourologic procedures include cystoscopy for treatment of prostatic enlargement/obstruction or bladder tumors and ureteroscopy for treatment of bladder stones. A wide variety of anesthetic techniques may be used, including monitored anesthesia care (MAC), neuraxial and general anesthesia.

Major urologic procedures include radical prostatectomy, radical or partial nephrectomy, and radical cystectomy. A discussion of the anesthetic concerns related to these procedures includes preoperative evaluation, patient positioning, anesthetic techniques and postoperative pain control. Nephrectomy and cystectomy both carry a substantial risk of blood loss and as a result may require invasive monitors and immediate availability of blood products. Enhanced Recovery After Surgery (ERAS) protocols have widely been accepted in major urologic procedures; elements often included or adapted as part of these urologic care algorithms will additionally be discussed in this chapter


Endourologic procedure Transurethral resection of the prostate (TURP) TURP syndrome Radical robotic prostatectomy Nephrectomy Cystectomy Lithotripsy Enhanced recovery after surgery (ERAS) Steep trendelenberg position 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyOschner Medical CenterNew OrleansUSA

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