SERUM SODIUM DYNAMICS AND ITS CLINICAL RELEVANCE IN TRANSURETHRAL RESECTION OF PROSTATE SURGICAL PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 57
Abstract
BACKGROUND Many endourological procedures require the use of an irrigation fluid to dilate the operating field and to wash away debris and blood. A potential complication of such irrigation is systemic absorption of the fluid and serum electrolytes changes, particularly serum sodium to the extent that overt symptoms are produced. The aim of this descriptive study is to analyse serum sodium changes and its clinical relevance in benign prostatic hyperplasia patients who underwent transurethral resection of prostate. MATERIALS AND METHODS This descriptive study was done among 100 benign hyperplasia prostate patients without any comorbid illness underwent TURP in Urology Department, Thanjavur Medical College Hospital, Thanjavur, Tamilnadu, in between period from February 2015 to January 2017. Preoperative and postoperative serum sodium levels correlated with signs and symptoms developed with various age groups, various prostate gland sizes, resection times and volume of irrigation fluids. Statistical tests used in this study are ANOVA followed by Tukey’s HSD test. RESULTS Sodium level has fallen by 14 mEq/L, raised by 2 mEq/L, postoperatively. Major fluctuation in serum sodium seen in 71-80 years age group patients; in 51-75 Gms group patients, resection time more than 60 Mints group patients, in 25-29 Litres irrigant group patients and in moderate TURP syndrome group patients. Severe TURP syndrome was not observed in any patient. Age is directly proportional to the degree of hyponatraemia. Mean sodium decrease (9.22 mEq/L) was highest in moderate TURP syndrome group. Degree of hyponatraemia directly proportional to blood pressure elevation, inversely related with pulse rate. CONCLUSION In patients aged more than 80 years without comorbid medical condition, it is better to complete procedure as quick as with low volume irrigation, aged less than 80 years and without comorbid medical conditions, larger glands up to 78 Gms maybe safely resected with the limit of 60 minutes resection time. In perioperative blood pressure and pulse rate monitoring will help to pick up TUR syndrome early
Authors and Affiliations
Jayaprakash Narayanan Karuppaiah, Ashok Kumar Rajagopalan
Keywords
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- EP ID EP226169
- DOI 10.14260/Jemds/2017/920
- Views 67
- Downloads 0
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