Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A...

Area of Science:

• Urology
• Surgical Complications
• Clinical Trials

Background:

• Transurethral resection of the prostate (TURP) is standard for benign prostatic hyperplasia (BPH).
• Monopolar TURP risks TUR syndrome, including hyponatremia and fluid overload.
• The study investigates furosemide's prophylactic effect against these complications.

Purpose of the Study:

• To evaluate the efficacy of prophylactic furosemide in preventing hyponatremia and TUR syndrome during monopolar TURP.
• To assess the impact of furosemide on serum sodium, potassium levels, and fluid balance.
• To determine complication rates and recovery times associated with furosemide use.

Main Methods:

• Triple-blind randomized clinical trial involving patients undergoing monopolar TURP.
• Patients were divided into furosemide and control groups.
• Primary outcomes: serum sodium changes and hyponatremia incidence; secondary outcomes: fluid balance, complications, recovery.

Main Results:

• The furosemide group showed significantly lower hyponatremia incidence (P=0.008).
• Post-surgery serum sodium levels were higher in the furosemide group (P=0.011), while potassium levels were lower (P=0.003).
• Mild, manageable hypokalemia occurred, particularly in patients with baseline potassium < 4.1 mmol/L.

Conclusions:

• Preoperative furosemide effectively reduces TUR syndrome risk and hyponatremia during monopolar TURP.
• Furosemide's utility is limited by potential hypokalemia, requiring patient-specific evaluation.
• Further research is needed for optimal and safe application of furosemide in this context.