Computer-controlled monitoring of bladder pressure in the prevention of 'TUR syndrome': a randomized study of 53 cases.
OBJECTIVE
To evaluate the performance of a computer-controlled monitor of bladder pressure in the prevention of transurethral resection (TUR) syndrome.


METHODS
The in vitro pressure loss in catheters and endoscopes of different size was measured for irrigant flow rates of 0-500 mL/min to calibrate them before surgery. The calibrations were used in a computerized monitoring system designed to control bladder pressure during TUR of the prostate (TURP). The performance of the system was assessed in a randomized study of 53 patients with a prostate adenoma or carcinoma (Group A, 27 unmonitored patients; Group B, 26 monitored patients). The primary criterion for evaluating the absorption of irrigating fluid was the level of glycine in the blood.


RESULTS
When patients with capsule perforation were included in the analysis, there was no statistically significant difference in mean glycine absorption between the groups, although glycine levels were highest in Group A, particularly in those cases with perforation (four in Group A; two in Group B). When the results for patients with capsule perforation were excluded from the analysis, there was a significant difference in the incidence of irrigant absorption between the groups. The extent of absorption was not related to the duration of operation (which was shorter in Group B) nor to the weight of resection chippings.


CONCLUSIONS
The continuous computerized monitoring of bladder pressure during TURP effectively reduced the absorption of irrigant fluid, making the procedure safer for the patient and easier for the surgeon.
Hubert
J
J
Department of Urology, Centre Hospitalier Universitaire Brabois, Nancy, France.
Cormier
L
L
Gerbaud
P F
PF
Guillemin
F
F
Pertek
J P
JP
Mangin
P
P
D000236:Adenoma / Q000503:physiopathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000503:physiopathology / Q000601:surgery; D004724:Endoscopy; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009929:Organ Size; D011312:Pressure; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000601:surgery; D012680:Sensitivity and Specificity; D013577:Syndrome; D013813:Therapy, Computer-Assisted; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D014546:Urinary Catheterization; D014572:Urology / Q000295:instrumentation*