DOUBLE-BLIND RANDOMIZED STUDY OF SYMPTOMS ASSOCIATED WITH ABSORPTION OF GLYCINE 1.5-PERCENT OR MANNITOL 3-PERCENT DURING TRANSURETHRAL RESECTION OF THE PROSTATE

Purpose: We studied which irrigating fluid, glycine 1.5% or mannitol 3 %, is associated with the most favorable adverse effects profile when absorbed by the patient during transurethral resection of the prostate . Materials and Methods: Irrigating fluid bags containing mannitol 3% or glycine 1.5%, both with added ethanol 1% as an indicator of fluid a bsorption, were used in a randomized double-blind fashion during 394 t ransurethral prostatic resections. The incidence of 13 symptoms was st udied in 52 patients (13%) who absorbed more than 500 ml. fluid. Resul ts: The incidence of circulatory symptoms did not differ between the f luids but the risk of neurological symptoms, such as nausea, after tra nsurethral prostatic resection was 4.8 times higher when glycine 1.5% was absorbed (p <0.04). An increase of 1,000 ml. in the volume of irri gant absorbed increased the overall risk for circulatory symptoms by a factor of 3.4 (p < 0.03) and the risk of neurological symptoms by a f actor of 4.4 (p <0.02). Conclusions: Absorption of mannitol 3% during transurethral prostatic resection is associated with fewer neurologica l symptoms than glycine 1.5%.