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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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The renal tubule is divided into three parts: the proximal convoluted tubule (PCT), the Loop of Henle (LOH), and the distal convoluted tubule (DCT).
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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Irrigation fluid absorption syndrome during HoLEP: A case study.

Charlotte Slots1, Pieter Uvin1, Emma Van Damme2

  • 1Department of Urology, Algemeen Ziekenhuis Sint Jan, Bruges, Belgium.

Urology Case Reports
|October 14, 2022
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Summary

A rare irrigation fluid absorption syndrome occurred during HoLEP surgery for benign prostate hypertrophy. This case presented with metabolic acidosis and hyperchloremia, not hyponatremia, and resolved with diuretics.

Keywords:
Benign prostate hypertrophyHoLEPHyperchloremiaIrrigation fluid absorptionMetabolic acidosisTUR syndrome

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Area of Science:

  • Urology
  • Surgical Complications
  • Nephrology

Background:

  • Transurethral resection syndrome (TURS) is a rare complication of prostate surgery.
  • Historically associated with monopolar techniques, TURS incidence decreased with bipolar resection and Holmium laser enucleation of the prostate (HoLEP).

Observation:

  • A 74-year-old male experienced an irrigation fluid absorption syndrome during a HoLEP procedure for benign prostate hypertrophy.
  • The patient's presentation was characterized by metabolic acidosis and hyperchloremia, deviating from the typical hyponatremic pattern of TURS.

Findings:

  • Biochemical analysis revealed significant hyperchloremia and metabolic acidosis.
  • These findings suggest an alternative presentation of fluid absorption syndrome during HoLEP.

Implications:

  • This case highlights the need for vigilance regarding TURS, even with advanced techniques like HoLEP.
  • Recognizing atypical biochemical presentations is crucial for timely diagnosis and effective management of fluid absorption syndromes.
  • Diuretic therapy proved effective for rapid recovery in this patient.