A comparison between intermittent and continuous transurethral resection of the prostate

Area of Science:

• Urology
• Surgical Techniques
• Fluid Dynamics in Surgery

Background:

• Transurethral resection of the prostate (TURP) is a common procedure for benign prostatic hyperplasia.
• Managing irrigating fluid absorption during TURP is crucial to prevent complications like TURP syndrome.
• Optimizing TURP techniques aims to minimize fluid absorption and improve patient safety.

Observation:

• This study randomized 123 transurethral resections of the prostate into four groups based on continuous vs. intermittent irrigation and low (65 cm) vs. high (80 cm) irrigating fluid pressure head.
• Isotonic 5% mannitol solution was used as the irrigating fluid.
• Irrigating fluid absorption was quantified by measuring postoperative plasma mannitol levels.

Findings:

• The use of a trocar significantly reduced the average absorbed fluid volume.
• No significant difference in fluid absorption was observed between high and low irrigating fluid pressure head groups.
• Intraoperative bleeding, serum sodium decrease, resection time, and resection rate showed no significant differences across the four groups.

Implications:

• Employing a trocar during TURP may be a valuable strategy to mitigate irrigating fluid absorption.
• Current variations in irrigating fluid pressure head within the tested range do not appear to significantly influence fluid absorption or key surgical outcomes.
• Further research could explore other factors influencing fluid absorption during TURP.