Continuous versus intermittent flow irrigation in transurethral resection of the prostate

Ekengren, Jan; Hahn, Robert G.

doi:10.1016/0090-4295(94)90074-4

Cited by 25 publications

(26 citation statements)

References 15 publications

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“…The intravesical pressures recorded in the present study are similar to those encountered with the intermit tent-filling technique [1] and reported for suprapubic drainage without a trocar by us [6] and by Holmqvist et al [7], Thus, one cannot assume that the intravesical pres sure is low just because suprapubic drainage is performed with a trocar. Furthermore, the period of high pressure was twice as long as when the bladder was filled intermit tently [1].…”

Section: Discussionsupporting

confidence: 72%

Large-Sized Bladders Reduce Intravesical Pressure and Fluid Absorption during TURP Using the Suprapubic Trocar

Zhang

Ekengren²,

Hahn³

1996

Urol Int

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We studied whether the height of the irrigating fluid bags above the operating table and the capacity of the bladder influence intravesical pressure and fluid absorption during transurethral resection of the prostate (TURP) when evacuation is performed with Reuter’s trocar. For this purpose, the intravesical pressure was recorded continuously, and the fluid absorption was measured by the ethanol method during 30 TURP procedures. The bags were placed between 60 and 95 cm above the operating table, and the bladder capacity was measured before surgery started. The results show that the bladder capacity, but not the bag height, correlated with the intravesical pressure and the fluid absorption. Large-sized bladders were associated with lower pressures and smaller absorption. Rapid absorption ( > 30 ml/min) occurred at a maximum pressure of 2–3 kPa and a mean pressure of between 1 and 2 kPa. In conclusion, the size of the bladder is important to the intravesical pressure and to the fluid absorption during TURP when using the suprapubic trocar.

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Section: Discussionsupporting

confidence: 72%

Large-Sized Bladders Reduce Intravesical Pressure and Fluid Absorption during TURP Using the Suprapubic Trocar

Zhang

Ekengren²,

Hahn³

1996

Urol Int

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“…In our opinion the use of a continuous flow resectoscope may explain the absence of any significant absorption: the procedure is performed entirely at low pressure, therefore there is less likelihood of breaching the prostatic capsule and forcing the irrigant to enter the systemic circulation through the opened venous sinuses; furthermore, there is no need to empty the bladder periodically, thus avoiding bladder overdistension and shortening the time of resection. Regarding the principle that lowpressure irrigation decreases fluid absorption, some studies [22][23][24][25] support this view while other authors [26,27] have not found such a reduction. Obviously, a continuous flow irrigation technique does not eliminate the risk of outflow obstruction and low fluid pressure is never guaranteed throughout the intervention.…”

Section: Discussionmentioning

confidence: 69%

No Evidence of Fluid Absorption during Continuous Low-Pressure Transurethral Resection of the Prostate: Assessment by Measuring Expiratory Breath Ethanol Concentrations

Aragona¹,

Panza

Mangano

et al. 1999

Eur Urol

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“…Hanging the irrigation fl uid at a height not exceeding 60 cm in order to prevent high pressure in the prostatic fossa, which will have an increasing effect on absorption, and overdistention in the bladder, and also continuous fl ow resectoscopy that ensures low pressure with continuous fl ow are recommended [11,12] . In our study, irrigation fl uid was hung at a height of 60 cm in all the patients, and continuous fl ow resectoscopy was used.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Transurethral Resection and Plasmakinetic Transurethral Resection Applications with Regard to Fluid Absorption Amounts in Benign Prostate Hyperplasia

et al. 2006

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Introduction: We compare the absorption of irrigant fluid during gyrus plasmakinetic transurethral prostatectomy (PK-TURP) and transurethral resection of the prostate (TURP). Patients and Methods: 42 patients with clinical benign prostatic hyperplasia were randomly assigned to undergo PK-TURP or TURP. In the PK-TURP group 0.9% NaCl was used as an irrigation fluid and 1.5% glycine in the TURP group. By adding ethanol to the irrigation fluids 1% ethanol-containing solutions were formed. All operations were carried out under spinal anesthesia and alcohol concentration of the ventilated air measurements were made just at the beginning of the operation, every 10 min peroperatively and at the end of the operation by using an alcoholmeter. Results: There was no difference in age, prostate volume and the length of operation time in either group. In both groups, the estimated absorbed fluid volume increased with the duration of surgery (p < 0.05). The difference between mean fluid absorption during PK-TURP and during TURP was the statistically significant (p < 0.01). Conclusion: PK-TURP operation causes lesser absorption of the irrigation fluid than the TURP operation. The lesser absorption of irrigation fluid and using saline instead of glycine decreases the risk of TUR syndrome.

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Continuous versus intermittent flow irrigation in transurethral resection of the prostate

Cited by 25 publications

References 15 publications

Large-Sized Bladders Reduce Intravesical Pressure and Fluid Absorption during TURP Using the Suprapubic Trocar

Large-Sized Bladders Reduce Intravesical Pressure and Fluid Absorption during TURP Using the Suprapubic Trocar

No Evidence of Fluid Absorption during Continuous Low-Pressure Transurethral Resection of the Prostate: Assessment by Measuring Expiratory Breath Ethanol Concentrations

Comparison of Transurethral Resection and Plasmakinetic Transurethral Resection Applications with Regard to Fluid Absorption Amounts in Benign Prostate Hyperplasia

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