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Fluid absorption during transurethral prostatectomy.

J R Logie, R A Keenan, P H Whiting

    British Journal of Urology
    |December 1, 1980
    PubMed
    Summary
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    Transurethral resection (TUR) for benign prostatic hyperplasia can lead to mannitol absorption, causing low sodium levels and potentially dangerous hypotension and bradycardia. Careful monitoring of serum mannitol is crucial during the procedure.

    Area of Science:

    • Urology
    • Nephrology
    • Cardiology

    Background:

    • Benign prostatic hyperplasia (BPH) is a common condition in aging men.
    • Transurethral resection (TUR) of the prostate is a standard surgical treatment for BPH.
    • Mannitol is frequently used as an irrigating fluid during TUR procedures.

    Purpose of the Study:

    • To investigate the absorption of mannitol during transurethral resection of the prostate.
    • To assess the effects of absorbed mannitol on serum sodium levels and hemodynamic parameters.
    • To identify potential risks associated with high levels of intravascular mannitol.

    Main Methods:

    • A study involving 39 patients undergoing transurethral resection of the prostate for BPH.
    • Measurement of serum mannitol levels during and after the procedure.

    Related Experiment Videos

  • Monitoring of serum sodium levels, blood pressure, and heart rate.
  • Assessment of patient hydration status (hypovolemia).

    • Main Results:

    • Significant absorption of mannitol into the circulation was observed in patients.
    • A notable decrease in serum sodium levels correlated with mannitol absorption.
    • Patients with serum mannitol levels exceeding 4000 mg/l exhibited hypotension and bradycardia.
    • Hypovolemia was a common finding in patients with adverse hemodynamic changes.

    Conclusions:

    • Intravascular mannitol absorption can lead to dilutional hyponatremia and hemodynamic instability during TURP.
    • Hypotension and bradycardia in this context may be multifactorial, with intravascular mannitol playing a significant role.
    • Close monitoring of serum mannitol levels and hemodynamic status is essential in patients undergoing TURP with mannitol irrigation.