Transurethral Prostatectomy (turp) & Open



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Transurethral Prostatectomy 

(TURP) & Open 

Facility: 

(Affix identification label here) 

URN:  


Family name: 

Given name(s): 

Address: 

Date of birth: 

Sex:  

 M     


 F     

 I 


 

 

Page 1 of 2 



Continues over page ►►► 

 

v5.00 - 04/201



© The S


ta

te o


f Que

ensland


 (Qu

eensla


nd 

Health), 2011

Permission

 to


 repr

oduce


 sh

ould 


be 

sou


ght from

 ip_o


ffi

cer


@

heal


th.q

ld.go


v.au

SW9304 


DO NOT WRI

T

E IN THIS B



INDING MARGIN 

A.  Interpreter / cultural needs 

An Interpreter Service is required? 

 Yes  

 No 


If 

Yes

, is a qualified Interpreter present? 

 Yes  

 No 


A Cultural Support Person is required? 

 Yes  


 No 

If 


Yes

, is a Cultural Support Person present?   Yes    No 



B.  Condition and treatment 

The doctor has explained that you have the following 

condition: 

(Doctor to document in patient’s own words

)

 

...........................................................................................................................................................................  



This condition requires the following procedure. 

(Doctor 

to document - include site and/or side where relevant to 

the procedure) 

...........................................................................................................................................................................  

...........................................................................................................................................................................  

The following will be performed: 

A telescope about the thickness of a pen is passed into 

the urethra and bladder. This telescope contains an 

electrical loop that cuts tissue and seals blood vessels.  

The obstructing part of the prostate gland, which is 

causing the blockage around the urethra, is cut away 

with the electrical loop to clear the channel. The prostate 

is NOT entirely removed. 

C.  Risks of a transurethral prostatectomy 

(TURP) & open 

There are risks and complications with this procedure. 

They include but are not limited to the following. 

General risks: 

 

Infection can occur, requiring antibiotics and further 



treatment. 

 

Bleeding could occur and may require a return to the 



operating room. Bleeding is more common if you 

have been taking blood thinning drugs such as 

Warfarin, Asprin, Clopidogrel (Plavix or Iscover) or 

Dipyridamole (Persantin or Asasantin). 

 

Small areas of the lung can collapse, increasing the 



risk of chest infection. This may need antibiotics and 

physiotherapy. 

 

Increased risk in obese people of wound infection, 



chest infection, heart and lung complications, and 

thrombosis. 

 

Heart attack or stroke could occur due to the strain 



on the heart. 

 

Blood clot in the leg (DVT) causing pain and 



swelling. In rare cases part of the clot may break off 

and go to the lungs. 

 

Death as a result of this procedure is possible. 



Specific risks: 

 

Bleeding is common during the operation and 



occasionally may require a blood transfusion. 

 

Late bleeding can occur up to six weeks after the 



operation from the raw surface where the prostate 

tissue was removed. This results in blood in the 

urine and, rarely, blockage of the urine flow needing 

insertion of a catheter. 

 

Mild to moderate difficulty with getting an erection 



may occur due to nerve damage from the surgery. 

 

The semen is likely to pass into the bladder during 



sex rather than down the urethra. This may result in 

difficulty with fertility and may affect sexual activity. 

 

When the catheter is removed, inability to pass urine 



may occur due to bladder muscle weakness. The 

catheter may need to be replaced for a few days to 

allow the bladder muscles recover. 

 

Swelling and pain can occur in the testicles due to 



inflammation or infection. Treatment is usually rest 

and antibiotics. 

 

A stricture (scar causing narrowing) can form in the 



urethra or at the bladder neck. This may need to be 

repaired with a further operation. 

 

Some urinary incontinence may happen after 



surgery. 

 

Injury to the rectum during the operation. Further 



surgery may be needed to repair the injury. This 

may need a bigger cut and a longer stay in hospital. 

If the bowel needs surgery, there is a possibility of a 

temporary or permanent stoma bag. 

 

One patient in six does not feel their symptoms 



improve following the surgery. 

D.  Significant risks and procedure options 

(Doctor to document in space provided. Continue in 

Medical Record if necessary.) 

...........................................................................................................................................................................  

...........................................................................................................................................................................  

...........................................................................................................................................................................  

...........................................................................................................................................................................  

E.  Risks of not having this procedure 

(Doctor to document in space provided. Continue in 

Medical Record if necessary.) 

...........................................................................................................................................................................  

...........................................................................................................................................................................  

...........................................................................................................................................................................  



F. Anaesthetic 

This procedure may require an anaesthetic.



 (Doctor to 

document type of anaesthetic discussed)

 

...........................................................................................................................................................................  



...........................................................................................................................................................................  

PROCEDURAL CONSENT FORM



 

 

 



Transurethral Prostatectomy 

(TURP) & Open 

Facility: 

(Affix identification label here) 

URN:  


Family name: 

Given name(s): 

Address: 

Date of birth: 

Sex:  

 M     


 F     

 I 


 

 

Page 2 of 2 



 

 

04/2011 - v5.0



DO NOT WRI

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INDING MARGIN 

G. Patient consent 

I acknowledge that the doctor has explained; 

 

my medical condition and the proposed 



procedure, including additional treatment if the 

doctor finds something unexpected. I understand 

the risks, including the risks that are specific to 

me. 


 

the anaesthetic required for this procedure. I 

understand the risks, including the risks that are 

specific to me. 

 

other relevant procedure/treatment options and 



their associated risks. 

 

my prognosis and the risks of not having the 



procedure. 

 

that no guarantee has been made that the 



procedure will improve my condition even though 

it has been carried out with due professional care. 

 

the procedure may include a blood transfusion.  



 

tissues and blood may be removed and could be 

used for diagnosis or management of my 

condition, stored and disposed of sensitively by 

the hospital. 

 

if immediate life-threatening events happen 



during the procedure, they will be treated based 

on my discussions with the doctor or my Acute 

Resuscitation Plan. 

 

a doctor other than the Consultant may conduct 



the procedure. I understand this could be a doctor 

undergoing further training. 



I have been given the following Patient 

Information Sheet/s: 

      About Your Anaesthetic OR 

      Epidural & Spinal Anaesthesia 

      Transurethral Prostatectomy (TURP) & 

Open 

      Blood & Blood Products Transfusion 

 

I was able to ask questions and raise concerns 



with the doctor about my condition, the proposed 

procedure and its risks, and my treatment 

options. My questions and concerns have been 

discussed and answered to my satisfaction. 

 

I understand I have the right to change my mind 



at any time, including after I have signed this form 

but, preferably following a discussion with my 

doctor. 

 

I understand that image/s or video footage may 



be recorded as part of and during my procedure 

and that these image/s or video/s will assist the 

doctor to provide appropriate treatment. 

On the basis of the above statements, 

 

I request to have the procedure 

Name of Patient:

..........................................................................................................................

 

Signature:



..........................................................................................................................................

 

Date:



......................................................................................................................................................

 

 



Patients who lack capacity to provide consent

Consent must be obtained from a substitute decision 

maker/s in the order below. 

Does the patient have an Advance Health Directive 

(AHD)?

 

 Yes 



Location of the original or certified copy of the AHD: 

................................................................................................................................................................

 

 

 No 



Name of Substitute  

Decision Maker/s:

...............................................................................................................

Signature:

.....................................................................................................................................

Relationship to patient:

.................................................................................................

Date:


.......................................................

  PH No:


..................................................................

Source of decision making authority (tick one): 

 Tribunal-appointed Guardian 

  Attorney/s for health matters under Enduring Power 

of Attorney or AHD 

  Statutory Health Attorney 

  If none of these, the Adult Guardian has provided 

consent. Ph 1300 QLD OAG (753 624)

 

 



 

 

H. Doctor/delegate 



Statement 

I have explained to the patient all the above points 

under the Patient Consent section (G) and I am of 

the opinion that the patient/substitute decision-

maker has understood the information.  

Name of  

Doctor/delegate:

.......................................................................................................................

 

Designation:

..................................................................................................................................

 

Signature:

........................................................................................................................................

 

Date:

......................................................................................................................................................

 

 

 



I. Interpreter’s 

statement 

I have given a sight translation in 



..................................................................................................................................................................... 

(state the patient’s language here)

 of the consent 

form and assisted in the provision of any verbal and 

written information given to the patient/parent or 

guardian/substitute decision-maker by the doctor. 

Name of  

Interpreter:

......................................................................................................................................

 

Signature:

........................................................................................................................................

 

Date:

......................................................................................................................................................

 


Consent Information - Patient Copy 

Transurethral Prostatectomy (TURP) & Open 

 

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© The S


ta

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f Que

ensland


 (Qu

eensla


nd 

Health), 2011

Permission

 to


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oduce


 sh

ould 


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ght from

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@

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th.q

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v.au

04/2011 - v5.0



1.  What do I need to know about this 

condition? 

The prostate gland is only found in males, and is 

situated below the bladder. The tube through which 

the urine passes from the bladder (the urethra), runs 

through the prostate, and then through the penis.  

Urine leaves the body through the urethra as does the 

semen during sexual intercourse. The main “valve” is 

a ring of muscle called the external sphincter which 

lies below the prostate gland. It controls the urinary 

flow. 


 

The position of the prostate gland 

The prostate gland produces a milky fluid, which helps 

make up semen. It does not produce any hormones 

and there are no changes to a man's nature or 

secondary sexual characteristics (such as deep voice, 

libido etc.) following removal of the prostate.  

In most men, beginning around the age of 40, there is 

a gradual enlargement of the prostate.  

This happens in varying amounts to different men. In 

some men, the enlarged prostate squeezes on the 

urethra to such an extent that it can slow the urinary 

stream.  

When this happens, the man may have difficulty 

starting the urine flow and a less strength of the 

urinary stream. 

 

2.  What are the effects of an enlarged 



prostate? 

Although enlargement of the prostate happens to all 

men, only 1 in 5 to 1 in 10 men will have problems 

needing surgery. These problems are: 



Urinary stream  

A weakening stream and difficulty in starting the urine 

flow. The bladder may fail to completely empty and 

may not feel empty even after passing urine. 

Sometimes a complete blockage of the urine occurs 

and a tube (catheter) has to be placed through the 

penis into the bladder to drain the urine away. This 

may happen with little warning but the patient has 

usually had previous problems with urine flow. 

Bladder effects 

The effect of urinary blockage by enlarging the 

prostate varies between men. In some men, the 

bladder muscle enlarges due to the increased force 

needed to empty the bladder. 

This causes bladder irritability and the man has to go 

to the toilet more frequently and may have to get up 

several times during sleeping hours to pass urine. 

An overactive bladder may also create the feeling of 

being unable to hold on to the urine and may cause 

leakage before getting to the toilet. 

In other men, the bladder muscle does not enlarge but 

becomes stretched and under-active. The bladder 

does not empty completely and urine remains in the 

bladder even after passing urine. This can go on to 

cause bladder infection and stones. 

In a small number of men, there may also be kidney 

damage and possibly kidney failure because of 

backpressure on the kidneys. 

 

3.  What do I need to know about the 



procedure? 

One or more of the above problems may require the 

removal of the part of the prostate gland, which is 

causing the blockage. 

Most men who have this operation do so because of 

the problems passing urine rather than for any medical 

complications. 

The aim of the operation is to remove the inner part of 

the prostate, which is pressing on the urethra. The 

whole prostate is not removed and a shell of prostatic 

tissue will remain. 

A cystoscopy (telescopic examination of the urethra, 

prostate and bladder) is usually performed just before 

the operation to help the surgeon decide which is the 

best operation for the patient. If the cystoscopy fails to 

find anything wrong with the prostate, the operation 

will not go ahead.

 

Transurethral resection of prostate (TURP) 

Most prostate operations are performed using a 

resectoscope, an instrument that is passed along the 

penis into the bladder. It has a telescope and an 

electrical cutting attachment that enables the doctor to 

view the prostate and remove in small pieces the part 

that is causing the blockage. 

Open prostatectomy 

Rarely, in some patients, a TURP may not be the best 

surgical method to treat their enlarged prostate 

because the prostate gland is too large or because 

their urethra or bladder is too small to be able to use 

the resectoscope. In these cases, an open 

prostatectomy operation may be done through a cut in 

the lower part of the abdomen to remove the prostate. 



Drugs before surgery 

It is important to check with your doctor if any 

prescription, herbal or over- the -counter drugs you are 

taking are known to cause thinning of the blood as this 

can increase the risk of bleeding.  

These drugs should not be taken for 2 weeks prior to 

surgery. If these drugs have been taken within the 2-


Consent Information - Patient Copy 

Transurethral Prostatectomy (TURP) & Open 

 

Page 2 of 5 



Continues over page ►►► 

04/2011 - v5.0

 

week period, it may be safer to postpone the operation 



to avoid the increased risk of bleeding. 

 

4. My 



anaesthetic 

This procedure will require an anaesthetic. 

See 

About Your Anaesthetic OR Epidural & Spinal 

Anaesthesia information sheets

 for information 

about the anaesthetic and the risks involved. If you 

have any concerns, discuss these with your doctor.  



If you have not been given an information sheet, 

please ask for one. 

 

5.  What are the benefits of having this 

procedure? 

Most men find the problems caused by the enlarged 

prostate are relieved. 

 

6.  What are the risks of not having this 



procedure? 

One in three men find that the symptoms may get 

worse and emergency treatment may be required if 

the prostate blocks the urine flow completely.  

 

7.  What are the risks of having this specific 

procedure? 

There are risks and complications with this procedure. 

They include but are not limited to the following. 

General risks: 

 

Infection can occur, requiring antibiotics and 



further treatment. 

 

Bleeding could occur and may require a return to 



the operating room. Bleeding is more common if 

you have been taking blood thinning drugs such 

as Warfarin, Asprin, Clopidogrel (Plavix or 

Iscover) or Dipyridamole (Persantin or Asasantin). 

 

Small areas of the lung can collapse, increasing 



the risk of chest infection. This may need 

antibiotics and physiotherapy. 

 

Increased risk in obese people of wound infection, 



chest infection, heart and lung complications, and 

thrombosis. 

 

Heart attack or stroke could occur due to the 



strain on the heart. 

 

Blood clot in the leg (DVT) causing pain and 



swelling. In rare cases part of the clot may break 

off and go to the lungs.  

 

Death as a result of this procedure is possible. 



 

 

 

 

 

 

Notes to talk to my doctor about: 

............................................................................................................................................................................ 

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- Specific risks continued on next page- 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

Consent Information - Patient Copy 

Transurethral Prostatectomy (TURP) & Open 

 

Page 3 of 5 



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© The S


ta

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f Que

ensland


 (Qu

eensla


nd 

Health), 2011

Permission

 to


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oduce


 sh

ould 


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sou


ght from

 ip_o


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04/2011 - v5.0



7. What are the risks of having this specific 

procedure? (Continued) 

Specific risks: 

 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

 

 



 

The risk 

What happens 

What can be done about it 

Excessive 

bleeding 

Blood loss during the operation. 

This may require a blood transfusion in 1 in 55. 

Not being able to 

pass water 

(urinary 

retention) 

Blood clots or swelling of the bladder 

neck stops the flow of urine following 

removal of the catheter in 1 in 14 men.  

The catheter may be replaced until the swelling 

has gone down and the bleeding has stopped. 

Most men will then be able to urinate normally. 

Late bleeding  

Late bleeding up to six weeks after 

surgery from the operation site in 1 in 

100 men. This results in blood in the 

urine and may block urine flow.  

The catheter may need to be reinserted to wash 

out any blood clots. A transfusion may be 

required. If the bleeding does not stop a further 

operation may be needed. 

Bladder muscle 

weakness 

Bladder muscle weakness may cause 

inability to pass urine. 

 

The catheter may need to be replaced after 



removal for a few days to allow the bladder 

muscles to recover.  



Pain in the 

testicles 

Swelling and pain in the testicles can 

occur due to inflammation. 

Treatment with rest and antibiotics. 



Infection 

Infection in the operation site or urinary 

tract occurs 1 in 20 men 

Treatment will be with antibiotics. 



Scarring of the  

bladder or 

urethra 

A stricture (scar) can develop in the 

urethra or the bladder. This can slow or 

block the urinary flow.  

The scar may need stretching or cutting to allow 

the urine to flow freely. This scar tissue can 

reform and need ongoing treatment. 

Difficulty getting 

an erection  

One in ten men find mild to moderate 

difficulty with getting an erection after 

the operation. 

Professional counselling, advice and medications 

are available. 



Retrograde 

ejaculation 

The semen passes backwards into the 

bladder during sex rather than down 

the urethra in most men. This will result 

in reduced fertility and may affect 

sexual activity. 

There is no treatment for this. If this is an issue 

alternate forms of therapy should be considered.   



Incontinence 

(loss of bladder 

control) 

Poor bladder control with urine leakage 

can occur following TURP. It usually 

improves in a few weeks but can rarely 

be permanent. 

Bladder control will usually improve with 

professional advice on continence management. 

Rarely a second operation may be necessary.  



Injury to rectum 

Very rarely, injury to the rectum can 

occur during the operation. 

Surgery to repair the injury may need a bigger cut 

and a longer stay in hospital. There is a possibility 

of temporary or permanent stoma bag to divert the 

faeces. 

Increased risks 

in obese 

patients. 

Obesity increases the risk of wound 

infection, chest infection, heart and 

lung complications and thrombosis. 

Weight loss before surgery is beneficial. 

Increased risk in 

smokers. 

Smoking slows wound healing and 

affects the heart, lungs and circulation. 

Giving up smoking before operation will help 

reduce the risk. 

Death due to surgical complications of trans urethral resection of prostate is about 1 in 200. 


Consent Information - Patient Copy 

Transurethral Prostatectomy (TURP) & Open 

 

Page 4 of 5 



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04/2011 - v5.0

 

8.  What are the alternative treatments to this 



procedure? 

Enlarged prostate - watchful waiting 

This is suitable for men who have mild or moderate 

symptoms who feel that they can manage. They may 

do well for years and not need surgery. 



Drug therapy 

There are a number of drugs and natural therapies 

that can be used to help relax or shrink the prostate. 

However side effects including dizziness and tiredness 

can occur depending on the type of drug. 

Trans-urethral incision of the prostate 

This minor procedure is for people who have a small 

prostate. A small cut is made in the prostate through 

the urethra to enlarge the opening and improve urine 

flow. 

Laser Prostatectomy 

This is a new treatment that is currently under study 

and not readily available. 

 

9.  What do I need to know about my recovery 



from the procedure? 

After the operation, the nursing staff will closely watch 

you until you have recovered from the anaesthetic. 

You will then go back to the ward where you will 

recover until you are well enough to go home. If you 

have any side effects from the anaesthetic, such as 

headache, nausea, vomiting, you should tell the nurse 

looking after you, who will be able to give you some 

medication to help. Your stay in hospital will probably 

be about 3-5 days, if you do not have any 

complications. 

 

Pain 



You can expect to have pain in the operation site. 

There are a number of ways in managing your pain. 

You may have:  

 

a drip with painkillers into the spine, which 



deadens the area below your waist 

 

a drip with painkillers that you can give to yourself 



when you feel pain 

 

tablets and injections. 



It is important that you tell the nursing staff if you are 

having pain. Your pain should wear off within 7 - 10 

days. If it does not, you must tell your Doctor.

 

 

Diet 



You will have a drip in your arm when you come back 

from surgery. This will be removed when you are able 

to eat and drink normally and you are no longer feeling 

sick. It is not unusual to feel sick for a day or two after 

surgery. Tell the nurse if this happens to you so that 

you can have drugs to stop it. To begin with, you can 

have small sips of water, then slowly take more until 

you are eating normally - this may be the evening of 

surgery for TURP patients but may be 1 or 2 days 

after surgery for men who have had open surgery. 

 

 

Bladder and urine  



A tube (known as a catheter) is passed into the 

bladder during the operation and will remain there 

after surgery until any heavy bleeding has stopped. 

The catheter may stimulate the inside of the bladder 

giving a sensation of a full bladder. It may also cause 

spasms, which make the bladder contract and urine to 

leak around the catheter.  

The nursing staff will check to make sure a blocked 

catheter is not the cause of these problems. The 

spasms usually go away once the catheter is 

removed. Irrigation may be attached to the catheter to 

flush the bladder and remove any clots or shreds of 

tissue that could otherwise block the catheter. The 

urine will be very bloody for 24- 48 hours after the 

operation.  

When the catheter is removed, the urine may flow with 

little warning and there may be some scalding. You 

should pass urine when you need to and not try to 

hold on at this stage. Most patients will regain bladder 

control by the time they leave hospital. Some men 

may however, have some urine leakage and 

frequency. This usually settles after a few months but 

there are a few men for whom this may become a 

long-term problem.  

Some men, who have difficulty passing urine once the 

catheter is removed, may have the tube replaced for a 

few days to a week. This usually settles although there 

will be a few men who will continue to have problems. 

If so, they will be taught how to put a tube into their 

bladder to empty it until the bladder muscle regains its 

strength. This can be done at home and may continue 

for several weeks. 

 

Bowels 


You may experience some difficulty with opening your 

bowels in the early days after surgery. This is usually 

treated with drugs to loosen the bowel motion. It is 

important to keep the bowel motions soft and regular 

as straining may cause bleeding. 

 

Sex 



After prostatectomy, the semen does not come out of 

the penis immediately after ejaculation. Instead, it 

passes into the bladder and then is passed out with 

the next flow of urine. Because of this, most men will 

be sterile although contraception should be used with 

a partner who is still able to have children, as some 

semen may leak.  

Most men, who were not having difficulty with normal 

orgasm and erections before surgery, should still be 

able to have normal orgasm and erections after 

surgery. Sexual intercourse should be avoided for six 

weeks after the surgery. 

 

Avoiding chest infections and blood clots 



It is very important after surgery to start moving as 

soon as possible. This is to prevent blood clots 

forming in your legs and possibly travelling to your 

lungs. This can be fatal.   

Also, you need to do your deep breathing exercises, 

ten deep breaths every hour, to get the secretions in 



Consent Information - Patient Copy 

Transurethral Prostatectomy (TURP) & Open 

 

Page 5 of 5 



 

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your lungs moving and help prevent a chest infection. 



At all costs, avoid smoking after surgery as this 

increases your risk of chest infection which causes 

coughing - a painful experience after surgery.  

 

Exercise 



It usually takes about 8 weeks to recover.  

You should avoid driving for four weeks after surgery. 

Do not lift heavy weights for at least 8 weeks after 

surgery. This is to allow healing to take place inside.  

 

10. What do I need to tell my doctor? 

Tell your doctor if you have; 

 

large amounts of bloody discharge from the penis. 



 

fever and chills. 

 

difficulty or inability to pass urine. 



 

pain that is not relieved by prescribed painkillers. 

 

swollen abdomen. 



 

Notes to talk to my doctor about: 

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Document Outline

  • Transurethral Prostatectomy (TURP) & Open - Procedural Consent Form
  • Consent Information - Patient Copy Transurethral Prostatectomy (TURP) & Open


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