Immediate detection of irrigant absorption during transurethral prostatectomy: case report

A transurethral prostatic resection is described in which immediate detection of a rapid massive irrigant absorption could be made by the use of ethanol-tagged irrigating fluid and repeated measurements of the ethanol concentration in the patient's expired breath. This monitoring enabled the surgeon to prevent further absorption by concluding the operation before symptoms resulted. Furosemide was given immediately to promote renal excretion of the absorbed irrigant, and the intravenous infusions were temporarily restricted to limit the intravascular fluid load. In retrospect, volumetric measurement showed that a total of 2410 ml of irrigant had been absorbed.