PURPOSE: Absorption of irrigation fluid was undetectable during greenlight laser vaporization (LV) of the prostate using the first-generation 80W laser.
However, data on intraoperative irrigation fluid absorption for the second-generation 120W high power laser is lacking. The purpose of this investigation was to assess whether fluid absorption occurs during high-power LV of the prostate.
MATERIALS AND METHODS: This prospective investigation was conducted in a tertiary referral center with patients undergoing 120W LV for prostatic bladder outlet obstruction. Normal saline containing 1% ethanol was used for intraoperative irrigation. Expired breath-ethanol concentrations were measured periodically during the operation using an alcometer. The volume of saline absorption was calculated from these concentrations. Intraoperative changes in hematological and biochemical blood parameters were also recorded.
RESULTS: Of 50 investigated patients, 22 (44%) had a positive breath-ethanol test. The median absorption volume in the absorber group was 725ml (range: 138-3452ml). Ten patients absorbed more than 1000ml. Absorbers had smaller prostates, more capsular perforations, a higher bleeding intensity, and more laser energy was applied during their operations. Three patients (13%) had symptoms potentially related to fluid absorption. Hemoglobin, hematocrit and serum chloride were the only blood parameters, which changed significantly in the absorber group and showed a significantly different change in the group of absorbers compared to non-absorbers.
CONCLUSIONS: Fluid absorption occurs frequently during high-power LV of the prostate. It should be taken into consideration in patients presenting with cardiopulmonary or neurological symptoms during or after the procedure.
Written by:
Hermanns T, Grossmann NC, Wettstein MS, Fankhauser CD, Capol JC, Poyet C, Hefermehl LJ, Zimmermann M, Sulser T, Müller A. Are you the author?
Department of Urology, University Hospital, University of Zürich, Zürich, Switzerland; Institute of Anaesthesiology, University Hospital, University of Zürich, Zürich, Switzerland.
Reference: J Urol. 2014 Aug 6. pii: S0022-5347(14)04159-7.
doi: 10.1016/j.juro.2014.07.117
PubMed Abstract
PMID: 25108273
