Patterns of Irrigating Fluid Absorption During Transurethral Resection of the Prostate as Indicated by Ethanol

Hahn, Robert G.; Ekengren, Jan

doi:10.1016/s0022-5347(17)36129-3

Cited by 98 publications

(53 citation statements)

References 18 publications

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“…Extensive tissue ablation has been identified as a risk factor for fluid absorption during TURP. 22 In contrast, smoking, a high ASA score, anticoagulation and urinary tract infections of which some were previously identified as risk factors for fluid absorption 11,14 , were not obviously associated with absorption in our investigation. It seems that the experience of the surgeon does not influence the risk of fluid absorption.…”

Section: Resultscontrasting

confidence: 73%

Absorption of Irrigation Fluid Occurs Frequently during High Power 532 nm Laser Vaporization of the Prostate

et al. 2015

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Purpose Absorption of irrigation fluid was not detected during GreenLight™ laser vaporization of the prostate using the first generation 80 W laser. However, data are lacking on intraoperative irrigation fluid absorption using the second generation 120 W high power laser. We assessed whether fluid absorption occurs during high power laser vaporization of the prostate. Materials and Methods We performed this prospective investigation at a tertiary referral center in patients undergoing 120 W laser vaporization for prostatic bladder outlet obstruction. Normal saline containing 1% ethanol was used for intraoperative irrigation. The expired breath ethanol concentration was measured periodically during the operation using an alcometer. The volume of saline absorption was calculated from these concentrations. Intraoperative changes in hematological and biochemical blood parameters were also recorded. Results Of 50 investigated patients 22 (44%) had a positive breath ethanol test. Median absorption volume in the absorber group was 725 ml (range 138 to 3,452). Ten patients absorbed more than 1,000 ml. Absorbers had a smaller prostate, more capsular perforation, higher bleeding intensity and more laser energy applied during the operation. Three patients (13%) had symptoms potentially related to fluid absorption. Hemoglobin, hematocrit and serum chloride were the only blood parameters that changed significantly in the absorber group. The changes were significantly different than those in nonabsorbers. Conclusions Fluid absorption occurs frequently during high power laser vaporization of the prostate. This should be considered in patients who present with cardiopulmonary or neurological symptoms during or after the procedure. The purpose of this investigation was to assess whether fluid absorption occurs during highpower LV of the prostate. Materials and Methods:This prospective investigation was conducted in a tertiary referral center with patients undergoing 120W LV for prostatic bladder outlet obstruction. Normal saline containing 1% ethanol was used for intraoperative irrigation. Expired breath-ethanol concentrations were measured periodically during the operation using an alcometer. The volume of saline absorption was calculated from these concentrations. Intraoperative changes in hematological and biochemical blood parameters were also recorded. Results:Of 50 investigated patients, 22 (44%) had a positive breath-ethanol test. The median absorption volume in the absorber group was 725ml (range: 138-3452ml). Ten patients absorbed more than 1000ml. Absorbers had smaller prostates, more capsular perforations, a higher bleeding intensity, and more laser energy was applied during their operations. Three patients (13%) had symptoms potentially related to fluid absorption. Hemoglobin, hematocrit and serum chloride were the only blood parameters, which changed significantly in the absorber group and showed a significantly different change in the group of absorbers compared to non-absorbers. Conclusions:Fluid absorpt...

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Section: Resultscontrasting

confidence: 73%

Absorption of Irrigation Fluid Occurs Frequently during High Power 532 nm Laser Vaporization of the Prostate

et al. 2015

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“…3,4 Nevertheless, significant complications remain associated with TURP and the general morbidity rate of TURP is 18% and the overall mortality rate ranges between 0.17% and 0.77%. 3,[5][6][7][8][9][10] Due to significant complication rates observed following TURP, several studies have evaluated the safety and efficacy of new surgical techniques to potentially minimize the risks of TURP to treat lower urinary tract symptoms (LUTS) resulting from BPH. [1][2][3][4] Recent trials investigating for the optimal surgical treatment for BPH compare different modalities in terms of minimal invasiveness, postoperative complications, physiological changes and outcomes.…”

Section: Introductionmentioning

confidence: 99%

A clinical study comparing BIVAP saline vaporization of the prostate with bipolar TURP: Early complications, physiological changes and postoperative follow-up outcomes

Aydoğdu

Karakose

Atesci

2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(7-8):e485-9. http://dx.doi.org/10.5489/cuaj.1772 Published online July 18, 2014. Abstract Introduction:We compare BIVAP saline vaporization of the prostate with bipolar transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia. Methods: In total, we included 86 patients treated with BIVAP (n = 44) and bipolar TURP (n = 42). The inclusion criteria were maximum urinary flow rate (Qmax) ≤10 mL/s, International Prostate Symptom Score (IPSS) ≥16, and prostate volume measured with transrectal ultrasound scan between 30 and 80 mL. Serum electrolyte, hemoglobin, and hematocrit levels were determined preoperatively and postoperatively. All patients were evaluated at the postoperative first and third months and the IPSS score, post-void residual urinary volume (PVR), Qmax, and average urinary flow rate (Qave) were compared. Statistical analyses were performed using SPSS 16.0 program and statistical significance was set at p < 0.05. Results: Preoperative demographic characteristics were similar in the 2 groups. The mean operation time was significantly higher (p = 0.02) and hospitalization time was significantly lower (p = 0.04) in the BIVAP group when compared to the bipolar TURP group. There was no significant difference between 2 groups in terms of preoperative and postoperative serum electrolyte, hemoglobin and hematocrit levels. Postoperative complication rates were similar in the 2 groups. The only exception was the rate of severe dysuria, which was significantly higher in the BIVAP group. No statistical difference was noted between the groups in terms of postoperative follow-up results. Conclusion: Bipolar TURP is a safe and highly effective technique which can be used in the surgical treatment of benign prostatic obstruction with minimal side effects. BIVAP saline vaporization of the prostate seems to be a potential alternative to bipolar TURP with shorter hospitalization time.

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“…The alcolmeter was calibrated weekly using alcohol-in-air gas standards at 0.8 mg/mL blood equivalent. where EB-eth i is the expired breath ethanol concentration at the start of any 10-min period in mg/mL and D EB-eth the total change in this variable during the same period [15].…”

Section: Methodsmentioning

confidence: 99%

“…Many methods of measuring irrigant absorption have been investigated [6][7][8][9][10][11][12][13][14][15][16][17][18][19] but most have proved impractical or inaccurate. Two are more promising, i.e.…”

Section: Introductionmentioning

confidence: 99%

Validation of the ethanol breath test and on‐table weighing to measure irrigating fluid absorption during transurethral prostatectomy

et al. 2002

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Objective To determine the agreement between on-table weighing and the ethanol breath test in measuring the fluid absorption of patients during transurethral prostatectomy (TURP), and to assess the practicality of on- (14) g at a mean resection rate of 0.74 g/min. The mean (range) absorption using the balance was 456 ( -343 to 2486) mL, and using the ethanol breath test was 435 (44-2750) mL, with the mean of the differences being -17 mL, with a 95% confidence interval (CI) of -81 to -40, the 95% limits of agreement being -389 to 356 mL (95% CI -458 to -337 and 297 to 418 mL). Conclusions Both methods are comparable and measure irrigating fluid absorption to levels of accuracy that are useful clinically. Either method could (and should) be used in routine practice.

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Patterns of Irrigating Fluid Absorption During Transurethral Resection of the Prostate as Indicated by Ethanol

Cited by 98 publications

References 18 publications

Absorption of Irrigation Fluid Occurs Frequently during High Power 532 nm Laser Vaporization of the Prostate

Absorption of Irrigation Fluid Occurs Frequently during High Power 532 nm Laser Vaporization of the Prostate

A clinical study comparing BIVAP saline vaporization of the prostate with bipolar TURP: Early complications, physiological changes and postoperative follow-up outcomes

Validation of the ethanol breath test and on‐table weighing to measure irrigating fluid absorption during transurethral prostatectomy

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