Fluid absorption during transurethral prostatectomy

A study of 39 patients having a transurethral resection (TUR) of prostate for benign prostatic hyperplasia was carried out. Large quantities of mannitol, which was used as the irrigating fluid during the procedure, were found to enter the circulation. A corresponding fall in the serum sodium levels was noted. Those patients with serum mannitol levels greater than 4000 mg/l were noted to be hypotensive and have a bradycardia. These patients were nearly all hypovolaemic and the bradycardia was felt to be inappropriate. The possibility of this being due to a combination of factors including intravascular mannitol is considered.