How to master absorption during transurethral resection of the prostate: basic measures guided by the ethanol method

Area of Science:

• Urology
• Surgical Technology
• Patient Safety

Background:

• Transurethral resection of the prostate (TURP) involves irrigating fluid absorption, which can lead to complications.
• Minimizing irrigating fluid absorption is crucial for safe and effective TURP procedures.

Purpose of the Study:

• To evaluate the efficacy of basic measures to minimize irrigating fluid absorption during TURP.
• To assess the utility of the ethanol method for real-time guidance of surgeons during TURP.

Main Methods:

• Forty-six patients undergoing TURP were monitored using sterile water and 2% ethanol irrigation.
• Breath-alcohol monitoring assessed ethanol absorption every 5 minutes.
• Surgeons were alerted to absorption and implemented corrective measures based on real-time ethanol readings.

Main Results:

• Twenty-one of 46 patients showed ethanol absorption, with a mean absorption of 121 mL.
• No TURP procedures were terminated prematurely due to fluid absorption.
• Absorption events did not significantly impact operative duration, resected weight, or blood loss compared to non-absorption cases.

Conclusions:

• Early detection of irrigating fluid absorption via the ethanol method allows for timely intervention.
• The ethanol method serves as an effective alarm system to minimize absorption during TURP.
• This approach can prevent surgery interruptions and premature termination, enhancing patient safety.