Absorption of irrigation fluid occurs frequently during high power 532 nm laser vaporization of the prostate.
- Hermanns T Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland. Electronic address: thomas.hermanns@usz.ch.
- Grossmann NC Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Wettstein MS Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Fankhauser CD Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Capol JC Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Poyet C Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Hefermehl LJ Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Zimmermann M Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Sulser T Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- Müller A Department of Urology and Institute of Anaesthesiology (JCC), University Hospital, University of Zürich, Zürich, Switzerland.
- 2014-08-10
Published in:
- The Journal of urology. - 2015
ethanol
intraoperative complications
laser therapy
prostate
therapeutic irrigation
Absorption, Physiological
Aged
Aged, 80 and over
Ethanol
Humans
Intraoperative Care
Intraoperative Complications
Laser Therapy
Male
Middle Aged
Prospective Studies
Sodium Chloride
Therapeutic Irrigation
Transurethral Resection of Prostate
Urinary Bladder Neck Obstruction
English
PURPOSE
Absorption of irrigation fluid was not detected during GreenLight™ laser vaporization of the prostate using the first generation 80 W laser. However, data are lacking on intraoperative irrigation fluid absorption using the second generation 120 W high power laser. We assessed whether fluid absorption occurs during high power laser vaporization of the prostate.
MATERIALS AND METHODS
We performed this prospective investigation at a tertiary referral center in patients undergoing 120 W laser vaporization for prostatic bladder outlet obstruction. Normal saline containing 1% ethanol was used for intraoperative irrigation. The expired breath ethanol concentration was 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. Median absorption volume in the absorber group was 725 ml (range 138 to 3,452). Ten patients absorbed more than 1,000 ml. Absorbers had a smaller prostate, more capsular perforation, higher bleeding intensity and more laser energy applied during the operation. Three patients (13%) had symptoms potentially related to fluid absorption. Hemoglobin, hematocrit and serum chloride were the only blood parameters that changed significantly in the absorber group. The changes were significantly different than those in nonabsorbers.
CONCLUSIONS
Fluid absorption occurs frequently during high power laser vaporization of the prostate. This should be considered in patients who present with cardiopulmonary or neurological symptoms during or after the procedure.
Absorption of irrigation fluid was not detected during GreenLight™ laser vaporization of the prostate using the first generation 80 W laser. However, data are lacking on intraoperative irrigation fluid absorption using the second generation 120 W high power laser. We assessed whether fluid absorption occurs during high power laser vaporization of the prostate.
MATERIALS AND METHODS
We performed this prospective investigation at a tertiary referral center in patients undergoing 120 W laser vaporization for prostatic bladder outlet obstruction. Normal saline containing 1% ethanol was used for intraoperative irrigation. The expired breath ethanol concentration was 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. Median absorption volume in the absorber group was 725 ml (range 138 to 3,452). Ten patients absorbed more than 1,000 ml. Absorbers had a smaller prostate, more capsular perforation, higher bleeding intensity and more laser energy applied during the operation. Three patients (13%) had symptoms potentially related to fluid absorption. Hemoglobin, hematocrit and serum chloride were the only blood parameters that changed significantly in the absorber group. The changes were significantly different than those in nonabsorbers.
CONCLUSIONS
Fluid absorption occurs frequently during high power laser vaporization of the prostate. This should be considered in patients who present with cardiopulmonary or neurological symptoms during or after the procedure.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.juro.2014.07.117
- PMID 25108273
- Persistent URL
- https://folia.unifr.ch/global/documents/226642
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