A comparison of 1.5% glycine and 2.7% sorbitol-0.5% mannitol irrigants during transurethral prostate resection

Purpose: We performed a prospective randomized trial comparing glycine 1.5% with 2.7% sorbitol-0.5% mannitol irrigating solution. We evaluated blood l oss, fluid absorption, temperature change, cardiac effects and postoperativ e symptoms. Materials and Methods: Between April 1998 and July 1999, 205 treated patien ts were included in the statistical analysis. Intraoperative irrigating flu id absorption was measured with the patient on the operating table. Serum c ardiac troponin I was used as a marker of perioperative myocardial damage. Operative details were recorded, including the type of anesthesia, resectio n time and the weight of resected tissue. Postoperative symptoms were docum ented prospectively. Results: Mean patient age was not significantly different in the glycine an d sorbitol-mannitol groups. (72.1 versus 73.7 years). American Society of A nesthesiologists grade was also comparable. Median resection time was 27 mi nutes and resected tissue weighed a mean of 21 gm. The median resection rat e was 0.8 gm. per minute. Blood loss and temperature changes during resecti on were similar in the 2 groups. Overall median blood loss was 216 ml. and irrigant absorption was 140 ml. In the sorbitol-mannitol group significantl y less fluid was apparently absorbed during resection (median 88.2 versus 1 84.4 ml.). Analysis of the incidence of symptoms of the transurethral prost ate resection syndrome did not show any differences in the irrigant groups. Cardiac damage measured using troponin I also showed no significant differ ence in the 2 groups, although there was a high overall incidence of 7.5%. Conclusions: We noted no significant differences in 1.5% glycine and 2.7% s orbitol-0.5% mannitol as an irrigating solution for transurethral prostate resection.