Prevention of TUR syndrome by detection of trace ethanol in the expired breath.

Previous studies suggest that severe symptoms of the 'TUR syndrome' occur from transurethral prostatic resection only when the volume of irrigant absorbed exceeds 2000 ml. An ethanol-containing irrigating fluid was used in this study of 100 transurethral resections so that the irrigant absorption could be monitored by measuring ethanol in expired air. Fluid absorption was found in 41 patients, and in nine of them the volume of irrigant absorbed exceeded 1000 ml. Four of these operations were terminated promptly when the ethanol monitoring indicated rapid massive absorption that threatened to exceed 2000 ml. There were few and only mild adverse effects of the irrigant by following this regimen. It is concluded that ethanol monitoring makes it possible to prevent the TUR syndrome by selective termination of those operations in which large amounts of irrigant is absorbed.