Reliability of clinical assessment of fluid absorption in transurethral prostatic resection

We evaluated 5 frequently used clinical methods of assessing absorption of irrigation fluid during 118 transurethral prostatic resections. The use of an irrigating solution containing glycine 1.5% and ethanol 1% and subsequent analysis of the alcohol concentration in the exhaled breath (ethanol monitoring) served as control method. Most cases of fluid absorption in excess of 1,000 ml could be indicated from a combination of clinical observations made by the surgeon and the anaesthetic nurse, and by measuring the serum sodium concentration. 'False alarms' were common, however. The volumetric fluid balance did not accurately reflect absorption. We conclude that none of the routine methods alone was specific enough to suffice for detection of irrigation fluid.