Various methods of determining irrigating fluid absorption during transurethal resection of the prostate

Summary A review is presented of all methods, nonquantitative as well as quantitative, applied in the determination of absorption of irrigating fluids used during transurethral resection of the prostate. The nonquantitative methods are clinical observations of pulmonary edema, cerebral edema, cardiac failure, mental agitation, hypertension, hemolysis, large postoperative diuresis, unexplained decrease in hematocrit, transient bacteremia, osteomyelitis, hyperglycemia, and extravasation of contrast medium. To determine total absorption in clinical practice the volumetric or gravimetric methods are the most reliable. The use of radioindicators added to the irrigation fluid is recommended for discrimination between intravascular and extravascular absorption. For this purpose 131 I-macroaggregated human serum albumin has the most advantages: low radiation hazard with good sensitivity, possibility of quantitative external monitoring of intravascular absorption, short time delay of the activity accumulation, and additional quantitative measurement of extravascular absorption.This work was supported in part by the Deutsche Forschungsgemeinschaft.