Intravesical pressure and the TUR syndrome.
Intravesical pressure was measured continuously during 35 transurethral prostate resections using a fine suprapubic catheter. Absorption of irrigating fluid was detected by tagging it with ethanol and sampling the expired breath using an alcohol meter. Higher mean (SD) intravesical pressure was demonstrated in those patients who absorbed irrigating fluid (19.1 (7.7) mmHg) than in those who did not (12.4 (6.5) mmHg; p = 0.00004). Higher peak pressures were also demonstrated among absorbing patients. Traditional risk factors for fluid absorption, such as operator experience and resectate mass, were found to correlate with pressure exposure over time. Exposure to supranormal bladder pressure over time is the final common path for all causes of absorption. Vesical pressure monitoring may be a valuable feedback tool during difficult resections or operator training.
Gray
R A
RA
Department of Anaesthesia and Intensive Care, Stirling Royal Infirmary, Stirling FK8 2AU, UK. robgray@bigpond.com
Lynch
C
C
Hehir
M
M
Worsley
M
M
D000042:Absorption; D000368:Aged; D001944:Breath Tests; D000431:Ethanol; D006801:Humans; D008297:Male; D008365:Manometry; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012307:Risk Factors; D013577:Syndrome; D007507:Therapeutic Irrigation; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*; D001743:Urinary Bladder / Q000502:physiology*
D000431:Ethanol