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Good practice with fluid management in operative hysteroscopy.
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, California, Los Angeles, USA.
Hysteroscopic surgery requires a balance of continuous controlled irrigation and aspiration to distend the endometrial cavity to a degree that provides the clear and stable visual environment necessary for diagnostic and therapeutic procedures. Whereas the preferred distending solution should be isotonic and isonatremic, radiofrequency (RF) electrosurgery with monopolar instrumentation can only be performed with non-ionic (hyponatremic) solutions. Absorption of as little as 500 mL and certainly more than 1000 mL of non-ionic solutions can result in fluid overload and/or dilutional hyponatremia with potentially serious adverse effects under certain conditions and patient characteristics.
View Article and Find Full Text PDFNon-Surgical Bleeding and Transurethral Resection of the Prostate (TURP) Syndrome after TURP Surgery: A Case Report and Literature Review.
Pathophysiology
July 2024
Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
Patients undergoing transurethral resection of the prostate (TURP) surgery can develop TURP syndrome and post-TURP bleeding. Post-TURP bleeding can be surgical, from arteries or venous sinuses, or non-surgical, due to coagulopathy preventing clot formation. Non-surgical post-TURP bleeding may be due to high concentrations of urokinase and tissue plasminogen activator (tPA) in the urine that cause fibrinolytic changes and increase bleeding risk.
View Article and Find Full Text PDFComparison of holmium laser enucleation and transurethral resection of prostate in benign prostatic hyperplasia: a systematic review and meta-analysis.
J Int Med Res
August 2023
Department of Anesthesiology, Shehong People's Hospital, Sichuan Province, China.
Transurethral resection of the prostate (TURP) is the gold-standard classical method for the treatment of benign prostatic hyperplasia (BPH). In minimally invasive surgery, holmium laser enucleation of the prostate (HoLEP) is considered an alternative option. In this systematic review and meta-analysis, we aimed to comprehensively evaluate the advantages and disadvantages of TURP and HoLEP the treating BPH.
View Article and Find Full Text PDFTransurethral resection of the prostate syndrome with severe lactic acidosis due to the use of sorbitol-mannitol irrigating fluid: A case report.
Urol Case Rep
January 2023
Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, Busan, Republic of Korea.
We report a case of transurethral resection of the prostate (TURP) syndrome with mild hyponatremia, severe lactic acidosis, and hypotension. A 73-year-old man with benign prostatic hyperplasia underwent monopolar TURP. Two episodes of hypotension occurred during the operation.
View Article and Find Full Text PDFIrrigation fluid absorption syndrome during HoLEP: A case study.
Urol Case Rep
November 2022
Department of Anesthesiology, Algemeen Ziekenhuis Sint-Lucas, Bruges, Belgium.
The classical transurethral resection syndrome as described with monopolar prostate resection has become rare since the switch to bipolar resection and even more so since the introduction of HoLEP. We report a case of a 74-year-old male patient who presented with an irrigation fluid absorption syndrome during a HoLEP for benign prostate hypertrophy. Biochemically this presented as metabolic acidosis and hyperchloremia instead of hyponatremia.
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