Determination and its significance of the amount of irrigating fluid absorbed during TURP by use of plasma sorbitol concentration

Park, Jong Gag; Lee, Sung Choon

Abstract

The main problems of transurethral prostatectomy were intraoperative blood loss and absorption or irrigating fluid. The reduced serum sodium concentration and osmolality. regarded as cause of TURP syndrome. was caused by dilution by several liters of irrigating fluid. Early recognition. while surgery is being performed is important to prevent development of hypovolemia. especially in the aged group. From January 1990 to June 1990. prospective study for the determination of the amount of irrigating fluid absorbed by use of plasma sorbitol concentration, serum electrolytes change and other related factors was undertaken in 30 patients undergoing TURP with manufactured URIONE solution (sorbitol 2.7 gm+mannitol 0.54 gm/100 ml distilled water) as irrigating fluid. An accurate measurement of plasma sorbitol concentration absorbed was obtained by Beutler`s enzymatic sorbitol analysis. Statistical evaluation of all data obtained was made using the `t-test` with significance at 0.1 percent or less. Mean plasma sorbitol concentration absorbed, blood loss. absorbed irrigating fluid volume were 474.2+/-344.3 mg/1.216 ml and 554.3+/-300.2 ml, respectively. A statistically significant positive interrelationship was found among absorbed plasma sorbitol concentration, serum sodium change and absorbed irrigating fluid volume (p<0.001). Also significant correlations could be obtained between absorbed irrigating fluid volume and serum sodium change (p<0.001).