Glycine 1.5% for irrigation should be abandoned

Area of Science:

• Urology
• Surgical Irrigation Solutions
• Patient Safety

Background:

• Glycine 1.5% is a widely used irrigating solution for monopolar transurethral resection of the prostate (TURP).
• Its use extends to other transurethral procedures.

Purpose of the Study:

• To review experimental and clinical studies on glycine 1.5% irrigation during TURP.
• To compare outcomes of glycine 1.5% with other irrigating fluids.

Main Methods:

• Systematic review of 11 animal studies, 3 volunteer studies, and 6 patient studies.
• Evaluated infusion/absorption of glycine 1.5% and compared outcomes to other fluids, including saline.

Main Results:

• Most studies indicated poorer outcomes with glycine 1.5% or higher toxicity with glycine 2.2% compared to glycine 1.5%.
• Adverse outcomes included increased tissue damage, higher mortality in animals, and more symptoms in volunteers and patients.

Conclusions:

• Glycine 1.5% irrigation may compromise safety during monopolar TURP.
• Replacing glycine 1.5% with electrolyte-free fluids is recommended to enhance patient safety.
• Complete abandonment of glycine 1.5% is advocated.