Hypertonic saline infusion as a prophylaxis against transurethral resection syndrome

ABSTRACT

Transurethral resection [TUR] syndrome is a well known complication that occurs during or after transurethral resection of the prostate from the absorption of irrigating fluids. In an attempt to prevent this mishaps, 60 patients subjected to transurethral resection of the prostate were studied. They were divided into two groups The first group [30 patients] received intravenous isotonic saline [0.9%] and the second group [30 patients] received intravenous hypertonic saline [3%]. The incidence of nausea, vomiting and mental confusion were significantly less in hypertonic saline group than isotonic group. Also, the serum Na and osmolality were significantly lower in isotonic than hypertonic group. Serum Na decreased from 142 +/- 6.2 mEq/l to 125.8 +/- 6.1 mEq/l in group I and from 138.2 +/- 5.8 mEq/l to 129.1 +/- 6.3 mEq/l in group II after three hours. The serum osmolality decreased from 298.2 +/- 12.5 mOsm/kg to 274.2 +/- 13.1 mOsm/kg in group I and from 302.1 +/- 9.5 mOsm/kg to 279.3 +/- 9.9 mOsm/kg in group II. These results confirmed that hypertonic saline infusion minimizes the incidence of clinically manifested TUR syndrome as it titrates with the biochemical changes that occur with this syndrome. The use of hypertonic saline infusion encouraged resection of bigger prostates especially when using distilled water as an irrigating fluid