Transurethral resection syndrome: effect of the introduction into clinical practice of a new method for monitoring fluid absorption.

STUDY OBJECTIVE

To determine the effects of introduction of a new monitoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcohol.

STUDY DESIGN

Prospective clinical investigation, with implementation of statistical process control.

SETTING

Inpatients for TURP at a major non-university teaching hospital.

PATIENTS

312 male ASA physical status I, II, III, and IV patients scheduled for TURP.

INTERVENTIONS

Intraoperative breath alcohol levels were measured for detection of fluid absorption.

MEASUREMENTS AND MAIN RESULTS

Calculation of the amount of fluid absorbed using measured breath alcohol values. Process variability (i.e., numbers of patients with significant fluid absorption) was defined by statistical process control tools. No trend change of prevalence of fluid absorption was noted until 150 procedures had been completed. Reduction of prevalence of significant fluid absorption was noted and no patients were treated postoperatively in the intensive care unit. No relevant side effects were seen in patients with significant fluid absorption. No mortality and no severe clinical morbidity was seen after the introduction of the new monitoring.

CONCLUSION

Using an irrigating fluid marked with 0.5% ethanol resulted in a decreased prevalence of fluid absorption over time.