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A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia

BACKGROUND: Central nervous system changes, circulatory and electrolyte imbalances are the main complications of endoscopic transurethral resection of the prostate (TURP) which is known as transurethral resection (TUR) syndrome, which occurs as result of excessive absorption of irrigating fluid. We...

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Autores principales: Yousef, Ayman A, Suliman, Ghada A, Elashry, Osama M, Elsharaby, Mahmoud D, Elgamasy, Abd El-naser K
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891743/
https://www.ncbi.nlm.nih.gov/pubmed/20509864
http://dx.doi.org/10.1186/1471-2253-10-7
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author Yousef, Ayman A
Suliman, Ghada A
Elashry, Osama M
Elsharaby, Mahmoud D
Elgamasy, Abd El-naser K
author_facet Yousef, Ayman A
Suliman, Ghada A
Elashry, Osama M
Elsharaby, Mahmoud D
Elgamasy, Abd El-naser K
author_sort Yousef, Ayman A
collection PubMed
description BACKGROUND: Central nervous system changes, circulatory and electrolyte imbalances are the main complications of endoscopic transurethral resection of the prostate (TURP) which is known as transurethral resection (TUR) syndrome, which occurs as result of excessive absorption of irrigating fluid. We compare glycine 1.5% versus glucose 5% and normal saline 0.9% as irrigating solutions during TURP in patients with moderate to severe bladder outlet obstruction due to benign prostatic hyperplasia (BPH). METHODS: Three hundred sixty patients with symptomatic BPH were randomized into a prospective, controlled trial comparing the three irrigation modalities. One-hundred twenty patients used glycine 1.5% solution as irrigating fluid (glycine group), 120 patients used glucose 5% solution (glucose group) and 120 patients used normal saline 0.9% solution (saline group). Patient's demographics, operation time, hospital stay, postoperative amino acid glycine assay, postoperative serum cardiac troponin I and perioperative complications were noted. RESULTS: No difference was found between the groups in the immediate postoperative levels of hemoglobin and hematocrite. A high glycine level was associated with the TUR syndrome. Seventeen patients had TUR syndrome; all were in glycine group and they had the highest postoperative amino acid glycine levels. Slight increase in serum sodium (142.6 ± 12.6 mmol/l) was detected in saline group. Transient Hyperglycemia (170 ± 35.9 mg/dl) and hypokalemia (3.67 ± 0.92 mmol/l) occurred in the immediate postoperative period in the glucose group. CONCLUSION: Endoscopic TURP performed using either glucose 5% or saline 0.9% irrigating solution during and after surgery is associated with lower incidence of TUR syndrome, lower catheterization period, shorter hospital stay and no cardiac toxicity in comparison with glycine 1.5% solution. TRIAL REGISTRATION: This clinical trail had been approved and registered in PACT Registry; with identification number for the registry is ATMR2010010001793131.
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spelling pubmed-28917432010-06-25 A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia Yousef, Ayman A Suliman, Ghada A Elashry, Osama M Elsharaby, Mahmoud D Elgamasy, Abd El-naser K BMC Anesthesiol Research article BACKGROUND: Central nervous system changes, circulatory and electrolyte imbalances are the main complications of endoscopic transurethral resection of the prostate (TURP) which is known as transurethral resection (TUR) syndrome, which occurs as result of excessive absorption of irrigating fluid. We compare glycine 1.5% versus glucose 5% and normal saline 0.9% as irrigating solutions during TURP in patients with moderate to severe bladder outlet obstruction due to benign prostatic hyperplasia (BPH). METHODS: Three hundred sixty patients with symptomatic BPH were randomized into a prospective, controlled trial comparing the three irrigation modalities. One-hundred twenty patients used glycine 1.5% solution as irrigating fluid (glycine group), 120 patients used glucose 5% solution (glucose group) and 120 patients used normal saline 0.9% solution (saline group). Patient's demographics, operation time, hospital stay, postoperative amino acid glycine assay, postoperative serum cardiac troponin I and perioperative complications were noted. RESULTS: No difference was found between the groups in the immediate postoperative levels of hemoglobin and hematocrite. A high glycine level was associated with the TUR syndrome. Seventeen patients had TUR syndrome; all were in glycine group and they had the highest postoperative amino acid glycine levels. Slight increase in serum sodium (142.6 ± 12.6 mmol/l) was detected in saline group. Transient Hyperglycemia (170 ± 35.9 mg/dl) and hypokalemia (3.67 ± 0.92 mmol/l) occurred in the immediate postoperative period in the glucose group. CONCLUSION: Endoscopic TURP performed using either glucose 5% or saline 0.9% irrigating solution during and after surgery is associated with lower incidence of TUR syndrome, lower catheterization period, shorter hospital stay and no cardiac toxicity in comparison with glycine 1.5% solution. TRIAL REGISTRATION: This clinical trail had been approved and registered in PACT Registry; with identification number for the registry is ATMR2010010001793131. BioMed Central 2010-05-28 /pmc/articles/PMC2891743/ /pubmed/20509864 http://dx.doi.org/10.1186/1471-2253-10-7 Text en Copyright ©2010 Yousef et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research article
Yousef, Ayman A
Suliman, Ghada A
Elashry, Osama M
Elsharaby, Mahmoud D
Elgamasy, Abd El-naser K
A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title_full A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title_fullStr A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title_full_unstemmed A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title_short A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
title_sort randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia
topic Research article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891743/
https://www.ncbi.nlm.nih.gov/pubmed/20509864
http://dx.doi.org/10.1186/1471-2253-10-7
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