EVALUATION OF THE CHANGES OF ACID-BASE STATUS AND THE SERUM SODIUM CONCENTRATION IN TRANSURETRAL RESECTION OF PROSTATE

Abstract

Objective: Transurethral resection of the prostate (TURP) is endoscopic urological intervention used in the treatment of BPH. A possible complication in TURP procedure is systemic absorption of the hypotonic irrigation fluid known as TURP syndrome. Here we evaluate changes in the level of electrolyte and acid-base status during TURP, correlation of hyponatremia and acidosis in the appearance of TURP syndrome and the impact of the duration of the procedure on the level of hyponatremia and acidosis. Methods and results: 20 male patients were divided into 2 groups according to the length of intervention: Group 1 (n = 9) less than 60 minutes and Group 2 (n = 11) more than 60 minutes. All TURP procedures were performed under general anesthesia and sterile water was used as irrigant. The level of Na +, K + and Cl-, pH, bicarbonate, lactate, base excess and Hb were determined through arterial blood pre-, intra- and postoperatively. Conclusions: Postoperative values of the second group indicated significant hyponatremia and hypochloraemia compared to the preoperative values and acidosis with fall in pH of 7.41 to 7.37 compared to the first group of patients. Changes in both groups of patients are directly proportional to the volume of irrigation fluid, the duration of the procedure and the weight of the recessed prostatic tissue. In all of the cases there were changes in the examined variables, indicating a need for monitoring of electrolytes and acid-base parameters periand postoperatively as an opportunity for early detection and treatment of TURP syndrome.