THE EFFECT OF PROSTATIC CAPSULE PERFORATION ON THE ABSORPTION OF IRRIGATING FLUID DURING TRANSURETHRAL RESECTION

Thirty patients undergoing transurethral resection of the prostate usi ng ethanol-tagged irrigating fluid were investigated in order to study the effects of a breach in the prostatic capsule. Measurements were m ade of end-tidal ethanol (ET-ethanol) in the expired air, serum glycin e and sodium, haemoglobin, blood loss and volumetric determination of irrigating fluid absorption. Perforation of the prostatic capsule occu rred in 13 patients (Group P), with 17 judged to have no perforation ( Group NP). In all Group NP patients the ET-ethanol remained below 0.05 parts per thousand, serum sodium decreased by less-than-or-equal-to 3 mmol/I and serum glycine remained < 1.5 mmol/l. ET-ethanol was signif icantly increased in Group P, rising to between 0. 1 and 0.45 parts pe r thousand in 5 patients, 3 of whom showed a reduction in serum sodium > 5 mmol/l. Five patients in Group P demonstrated significantly raise d serum glycine concentrations up to 15 mmol/l. These findings suggest that perforation of the prostatic capsule may lead to rapid absorptio n of irrigating fluid, and that ET-ethanol monitoring is a useful meth od of detecting this quickly.