MASSIVE IRRIGATION DURING ENDOSCOPIC UROLOGIC SURGERY NORMAL SALINE VERSUS DISTILLED WATER; A PROSPECTIVE RANDOMIZED TRIAL

Document Type : Original Article

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Department of Anesthesia & Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

Background: Benign prostatic hyperplasia is the most prevalent non-malignant prostate disease affecting over 50% of the aging male population. Transurethral prostate resection (TURP) is the standard reference (i.e. the most effective endoscopic surgical procedure for this disorder). Aim of the study: To compare the effectiveness and safety of normal saline vs sterile distilled water in massive irrigation in urological endoscopic surgery (TURP) as regards electrolyte
disturbance (Na+ level), serum creatinine and occurrence of TURP syndrome. Patients and Methods: This study included fifty male patients with benign prostatic hyperplasia, aging 50-70 years old, admitted to operating room in Ain Shams University hospitals for TURP. The patients were divided into two equal groups, Group 1: underwent endoscopic urological surgery (TURP) with normal saline wash using bipolar resectoscope, Group 2: underwent endoscopic urological surgery (TURP) with distilled water wash using monopolar resectoscope. Results: The current study showed significant decrease in serum Na+ level in distilled water group than in normal saline group in both postoperative and 24 hr later. Also, we found significant decrease in hemoglobin level at 24hr postoperative in distilled water group compared to saline group.
Conclusion: Our results demonstrate that normal saline wash during TURP causes less drop-in serum sodium and Hb level, less fluid overload, less incidence of TURP syndrome and decreased need for blood transfusion than using distilled water as irrigant.

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