ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

GENITOURINARY ANESTHESIA

Esma Karaarslan

Konya City Hospital, Department of Anesthesiology and Reanimation, Konya, Türkiye

Karaarslan E. Genitourinary Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.329-340.

ABSTRACT

  • Genitourinary surgeries include transurethral interventions (e.g., cystoscopy, transurethral resection of the prostate [TURP], transurethral resection of bladder tumor [TURBT]), laparoscopic procedures, radical oncological surgeries, and minimally invasive stone treatments (percutaneous nephrolithotomy [PCNL], extracorporeal shock wave lithotripsy [ESWL]).
  • Anesthesia is customized according to the procedure and patient anatomy. For instance, flexible cystoscopy in females can be performed under topical anesthesia with IV sedation, whereas males often require regional or general anesthesia due to the longer urethra.
  • Spinal anesthesia is preferred for TURP because it facilitates the early detection of TURP syndrome and provides continuous neurological monitoring.
  • Procedures like nephrectomy, prostatectomy, and cystectomy typically require general anesthesia with vigilant hemodynamic and fluid management due to risks of significant blood loss and the challenges posed by positions (e.g., Trendelenburg, lateral decubitus).
  • Technological advances have made ESWL more comfortable-often performed with sedation-while PCNL remains the treatment of choice for large or complex renal stones under general anesthesia.
  • Proper positioning (supine, prone, lithotomy, Trendelenburg, lateral decubitus) is critical to minimize nerve injuries and other complications during lengthy procedures.

Keywords: Urogenital system; Anesthesia; Complication; Transurethral resection of prostate; Lithotripsy; Cystoscopy

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