Abstract
To investigate changes in body fluid distribution during transurethral prostatectomy (TURP) using 3 % sorbitol irrigant and to assess the causal factors of TURP Syndrome. A total of 61 patients were enrolled in the study. Irrigant absorbed (V-abs), blood loss (B-loss) and ΔICF and ΔECF (volume increased from initial intra- and extra-cellular fluid) were computed using laboratory data. We classified patients into either a TURP syndrome group (TURS) or an asymptomatic group (ASTM). Although B-loss was larger in TURS (mean 860 ml) than in ASTM (170 ml, p<0.01), there was no significant difference in V-abs (1740 vs. 1680 ml), ΔECF (760 vs. 1170 ml), and ΔICF (130 vs. 340 ml). The ΔECF in TURS was not sufficiently large to compensate for B-loss, whereas the ΔECF in ASTM was. We conclude that TURP syndrome is likely not caused by dilutional hyponatremia, but rather by bleeding and the resultant hypovolemia without appropriate extracellular fluid replenishment when 3% sorbitol is used as the irrigant.
