If TURP irrigation becomes blocked, what is the recommended action?

If TURP irrigation becomes blocked, what is the recommended action?

• A. Turn off CBI and use piston syringe to irrigate
• B. Increase infusion rate
• C. Ignore blockage
• D. Change patient position

Answer: (A)

Blockage of TURP irrigation is usually due to blood clots or debris sealing the catheter lumen, so the priority is to relieve the obstruction safely. Stopping the continuous bladder irrigation prevents further pressure buildup, then you clear the lumen with a piston syringe. Attach a 60 mL syringe filled with sterile saline to the catheter irrigation port and gently push saline in small, controlled boluses while watching for return flow and drainage. This manual irrigation dislodges clots and restores patency more safely than forcing more solution through the line. Once the lumen is clear, reestablish irrigation at a slow rate and verify continuous drainage. Check for other causes of blockage as you proceed, such as kinks in tubing or an occluded drainage bag, and ensure the collection bag is below bladder level. If the blockage cannot be cleared with manual irrigation, notify the provider and consider catheter replacement. Increasing the infusion rate would raise bladder pressure and worsening the problem; ignoring the blockage risks bladder distension and TURP complications; changing the patient’s position does not address the occluded catheter lumen.

Blockage of TURP irrigation is usually due to blood clots or debris sealing the catheter lumen, so the priority is to relieve the obstruction safely. Stopping the continuous bladder irrigation prevents further pressure buildup, then you clear the lumen with a piston syringe. Attach a 60 mL syringe filled with sterile saline to the catheter irrigation port and gently push saline in small, controlled boluses while watching for return flow and drainage. This manual irrigation dislodges clots and restores patency more safely than forcing more solution through the line. Once the lumen is clear, reestablish irrigation at a slow rate and verify continuous drainage.

Check for other causes of blockage as you proceed, such as kinks in tubing or an occluded drainage bag, and ensure the collection bag is below bladder level. If the blockage cannot be cleared with manual irrigation, notify the provider and consider catheter replacement.

Increasing the infusion rate would raise bladder pressure and worsening the problem; ignoring the blockage risks bladder distension and TURP complications; changing the patient’s position does not address the occluded catheter lumen.