Ethanol monitoring of the transurethral resection syndrome

Ethanol monitoring is a fairly new method of assessing fluid absorption during transurethral resection of the prostate (TURP). By using an irrigating fluid containing a trace amount of ethanol, the absorption can be measured by expired-breath tests. We describe a TURP in which large-scale absorption of irrigating fluid occurred despite the use of a pressure-warning device set at 10 cm H2O. The surgeon decided to terminate the operation because 1.0 liters of fluid had been absorbed over 10 minutes, and another 1.0 liter was absorbed during the 10 minutes required to conclude the surgery. The high absorption rate suggests that continued resection would have promoted a severe transurethral resection syndrome. This was prevented by the indication given by the breath test, whereas the pressure-warning device failed to do so.