Effects of distilled water and mixture of sorbitol-mannitol irrigation fluids on fluid-electrolyte balance in patients undergoing transurethral prostatectomy

Abstract

This study aimed to compare two various irrigation fluids used in transurethral prostatectomy (TURP) with respect to changes in fluid-electrolyte balance and to evaluate the blood loss during TURP. TURP was performed in 50 patients using distilled water and in 42 patients using a mixture of sorbitol and mannitol solution (2.7% sorbitol and 0.54% mannitol) as irrigation fluid. Fluid-electrolyte changes and blood loss were evaluated. None of the patients had transurethral resection syndrome. Decline in serum sodium level was more significant in patients who were operated on with the sorbitol plus mannitol irrigation fluid in contrast to its clinical insignificance (p < 0.05). Decrease in serum sodium concentration in patients with more than 15 g of tissue resected was greater than in patients with less than 15 g of tissue resected (p < 0.05). Blood loss was greater in the distilled water group (p < 0.05). Blood loss was 145.5 +/- 3.4 ml in patients given a blood transfusion. In conclusion, a fluid containing mainly sorbitol must be the irrigation fluid preferred over distilled water because of its non-haemolytic nature, but although not important clinically, it can cause hyponatraemia more than distilled water. Furthermore, it is useful to determine blood loss during TURP before deciding to give a blood transfusion.

Massive akute hypotone Hyperhydratation nach arthroskopischer Synovektomie

“…So wird Sorbit in der Leber zu Fruktose, Glukose und Laktat abgebaut. Von einigen Autoren [3,10]) wird der Einsatz einer isoosmolaren, also 5%igen Mannitlösung propagiert, da durch die mannitinduzierte osmotische Diurese gleichzeitig eine Therapie der Hyperhydratation erreicht wird, andererseits ist dann eine postoperative Hypovolämie zu befürch-ten [1,2].…”