Sorbitol-mannitol solution for urological electrosurgical resection - A safer fluid than glycine 1.5%

Objective: To evaluate the safety and suitability of sorbitol-mannitol solu tion (Purisole(R), Fresenius, Germany) as a fluid for irrigation during ele ctrosurgical resection of prostate (TURP). Patients and Methods: 120 sequen tial patients undergoing TURF were studied. Serum electrolytes were measure d before and the day after surgery. Time and weight of resection were recor ded. Use of blood transfusion was recorded. Results: There were no adverse effects attributable to the use of the irrigant. There were no technical, e lectrical or instrument problems. None of the surgeons had a ny difficultie s with clarity of view during resection when bleeding was light. There was no significant change in any of the serum electrolytes between pre-operativ e and postoperative values. No patient developed significant postoperative hyponatraemia or the 'TUR syndrome'. Conclusions: Purisole (sorbitol-mannit ol) solution is entirely satisfactory as an irrigant for electrosurgical re section and in the present study there were no measurable changes in patien ts' electrolytes around the time of surgery. What small changes occurred in dicate there is an overall mild dehydration effect through the process of s urgery, which may be in part attributable to irrigant, but this change was small and does not reach either clinical or statistical significance. Puris ole offers theoretical advantages over glycine solution and there are no ob vious disadvantages. The authors would thereby recommend it in preference t o glycine.