Objective To describe a modi®ed and improved technique which, in one measurement, estimates the in¯ux of irrigation¯uid during endoscopic endometrial ablation or prostate resection, and provides both rapid con®rmation of the diagnosis and an estimate of the amount of¯uid absorbed by detecting markers which pass from the irrigation¯uid to the serum, i.e. mannitol or sorbitol. Patients and methods Control samples were taken for analysis before irrigation, and test samples were taken on four occasions during and after intervention, from each of 10 patients undergoing transurethral resection of the prostate. Irrigation¯uid was also marked with ethanol (1.5% w/v) and the concentration of this agent measured in the blood and expired air of these patients. The absorbed volume was calculated according to the extracellular distribution space of mannitol. Results Mannitol and sorbitol could be measured in 85% and 73% of the 40 test samples, respectively. The threshold for full sensitivity for breath ethanol concentration to detect absorption was 132 mL. Conclusion This method for detecting serum mannitol and sorbitol represents a valid procedure for con®rm-ing and quantifying the absorption of irrigation¯uid in the clinic, which agrees closely with the already established ethanol monitoring procedure and which should now be considered as a reference procedure.

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