AN EXPERIMENTAL STUDY ON THE TRANSURETHRAL RESECTION REACTION

Abstract

Physiologic changes were observed following infusion of distilled water, 5% glucose and isotonic sorbitol-mannitol solution in dogs in order to clarify the cause and nature of the so called transurethral resection reaction. Thirty six dogs in total were divided into 3 groups. The infusion rate was relative rapid, 2.5cc/kg./min. in each group.
Marked bradycardia and elevation of systolic blood pressure were observed in every cases, especially in the group of distilled water. Decrease of hematocrit was marked in the distilled water group but not in the isotonic solution groups. Rapid decrease of blood pressure was not seen in every case in spite of marked hyponatremia. Active sodium loss through the kidney was not demonstrated in the isotonic solution groups, by means of sodium clearance change within the volume of absorption which is considered to occur actually in TURP. No marked difference was found between 5% glucose and sorbitol-mannitol solution on physiological changes.
It is preferred to avoid the use of distilled water as an irrigating fluid in TURP, considering the appearance of earlier and severe reaction.