Effect of irrigating fluid temperature on core body temperature during Transurethral resection of the prostate.

The objective of this study was to determine the effect of irrigating fluid temperature on core body temperature changes in patients undergoing transurethral resection of the prostate (TURP). A cross sectional study was conducted on 32 patients with benign prostatic hyperplasia (BPH) who underwent TURP at our institution between September 2003 and January 2004. Patients were randomized to one of two groups. Standard group consisted of 16 patients who received room temperature irrigating fluid (± 23.6 0C) throughout TURP. Isothermic group consisted of 16 patients whose procedure was performed using warmed irrigating fluid (± 37.2 0C). The irrigating fluid used for both groups was aquabidest. The age, resection time, weight of resected prostate, amount of irrigating fluid used, temperature in the operating theatre, core body temperature at beginning and at conclusion of TURP were recorded for each patient. The t test was used for comparison between both groups and a p value of 0.05 or less was considered significant. The result of this study showed a decrease of core body temperature during TURP, using either room temperature or warmed irrigating fluid (both p = 0.000). None of the patients in either group demonstrated any criteria of hypothermia. The average decrease of core body temperature in standard group (0.99 0C) was greater than in isothermic group (0.75 0C), but it was not significantly different (p > 0.05). In conclusion, our study revealed that using either room temperature irrigating fluid or warmed irrigating fluid during TURP could decrease core body temperature at approximately similar level, with no incidence of hypothermia.

Possible factors influencing high serum Prostate-specific Antigen (PSA) in Indonesian patients with Benign Prostatic Hyperplasia (BPH).

Benign prostatic hyperplasia (BPH) cases in Indonesia frequently associated with high serum prostate specific antigen (PSA). To explore possible factors that could increase serum PSA level, we performed a retrospective, cross-sectional study on 805 consecutive patients in Sumber Waras and Dr. Cipto Mangunkusumo Hospitals from 1994 to 1997. Clinical manifestations were evaluated and prostate biopsies were performed if indicated. Complete histopathological data were only available in 82 BPH patients with no urinary retention from 1998-1999 and a thin section of paraffin blocks of BPH patients which still could be found from 1994-1999 was analyzed using flow cytometer to obtain the S-phase fraction as a parameter of proliferative activity, From 805 patients, 461 (57%) presented with urinary retention and need to be catheteized. Catheteization significantly increased PSA level if compared to noncatheterized patients (16.3 vs. 6,8 ng/mL, p= 0,000). Another data of 82 uncatheteized patients from 1998-1999 has revealed that 79 patients (96.3%) had chronic prostatitis and 19 (23.2%) showed the presence of prostatic-intraepithelial neoplasia (PIN) with an increase of PSA level (5.4 ng/mL). The S-phase fraction of BPH without PIN cases was significantly higher in cases with PSA > 4 ng/ml than patients with PSA ≤ 4 ng/ml (I3.1% vs. 8.9%, p=0,008). As conclusion, the high serum PSA level was mostly due to urethral catheteization and increased prostate volume. There was a tendency of increasing PSA in subclinical inflammation and PIN. Cases with high PSA also showed high proliferative activities which is suggestive of mitogenic activity.