Effect of warm bladder irrigation fluid for benign prostatic hyperplasia patients on perioperative hypothermia, blood loss and shiver: A meta-analysis

OBJECTIVE: To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia, blood loss and shiver in patients treated with benign prostatic hyperplasia (BPH). METHOD: A comprehensive literature review and meta-analysis that included randomized controlled trials (RCTs) related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers. The relevant literature were searched in Chinese database, such as Retrieval Chinese Journal Full-text Database, VIP Journal Database, Wanfang database, as well as in English search engine and database, including Embase, Cochrane and Medline till January 2018. The study quality was assessed by recommended standards from Cochrane Handbook (version 5.1.0). RESULTS: A total of 28 RCTs and 3858 patients were included. The results showed that the incidences of shiver (risk ratio [RR] = 0.32, 95% confidence interval [CI]: 0.28–0.36, p < 0.001, I(2) = 0%) and hypothermia (RR = 0.36, 95% CI: 0.21–0.59, p < 0.001, I(2) = 67%) in the group of warm irrigation fluid were lower than the group having room-temperature fluid. Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group (p < 0.001, I(2) = 96%). We performed a narrative descriptive statistics only because of substantial heterogeneity. CONCLUSIONS: Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH. Warm irrigation fluid should be considered as a standard practice in BPH surgeries.