Metabolic consequences of forced diuresis following prostatectomy

The efficacy and metabolic consequences of a standardised forced diuresis regime following prostatectomy were studied in three parts. A retrospective review of 372 patients. A detailed prospective study of blood and urine electrolyte changes in 25 patients. A prospective study of urinary oxalate levels in 15 patients. The regime was effective in safely preventing post-operative clot retention. In 54% of patients the plasma sodium fell below 135 mmol/l. Hypokalaemia was mild and transient except in patients on long-term diuretics. There was a significant per-operative fall in serum calcium levels. It was concluded that forced diuresis is a safe and effective method of reducing clot retention following prostatectomy. The high incidence of post-operative hyponatraemia suggests that absorption of glycine solution at transurethral prostatectomy is a common occurrence.