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.

Ability of prostate specific antigen to predict bone scan result in prostate cancer patients.

The objective of this study is to assess the relation between serum prostate specific antigen (PSA), clinical tumor stage, tumor grade, and bone scan result in an attempt to seek the ability of serum PSA to predict bone metastases in newly diagnosed prostate cancer patients. A retrospective analysis was conducted on clinical files of prostate cancer patients which were diagnosed in our institutions between January 1995 and December 2003. Patients on which initial serum PSA were obtained after urethral manipulation or after receiving therapy were excluded. The results of bone scans were related to levels of serum PSA, clinical tumor stage, and tumor grade. Of 103 patients who were included in this investigation, 61 patients (59.2%) had a positive bone scan and 42 patients (40.8%) had a negative bone scan with mean PSA value 471.13 ± 853.34 ng/ml and 61.00 ± 124.47 ng/ml respectively (p < 0.05). The risk of having a positive bone scan increased with advancing serum PSA levels, clinical tumor stage, and tumor grade (p < 0.05). Using receiver operating characteristic curves, PSA had the best correlation with bone scan results (the area under curve was 0.812). Bone scan results were predicted best by the combination of serum PSA, clinical tumor stage, and tumor grade. Bone scans were positive in 5 of 19 patients with PSA level < 10 ng/ml. None of 8 patients with PSA levels < 10 ng/ml, clinical tumor stage T1 or 2 and tumor grade 1 or 2 had a positive bone scan. In conclusion, we suggest that routine bone scan examination may not be necessary in patients with newly diagnosed, untreated prostate cancer, who have serum PSA level < 10 ng/ml with clinical tumor stage T1 or 2 and tumor grade 1 or 2.