Biochemical and Haemodynamic Changes during Transurethral Resection of Prostate and Percutaneous Lithotripsy- An Observational Pilot Study

Abstract

Introduction: Fluid absorption and associated electrolyte derangement is an inevitable complication of Transuretheral Resection of Prostate (TURP) and Percutaneous Lithotripsy (PCNL) irrigation during transurethral resection of prostrate and PCNL. Aim: to analyse changes in serum electrolytes, Lactate Dehydrogenase (LDH) and acid base status, and to evaluate their role as early predictors of clinical and haemodynamic changes following continuous irrigation during transurethral resection of prostrate and PCNL. Materials and Methods: The present observational study was conducted on 20 patients, who underwent TURP and 20 patients who underwent PCNL. A 1.5% glycine and 0.9% normal saline were used for irrigation during TURP and PCNL, respectively. The levels of serum sodium, potassium, free calcium ion, LDH and acid base status were monitored in all patients preoperatively, intraoperatively, at the end of surgery, 6 hours and 24 hours postoperatively. Intraoperative and postoperative haemodynamic parameters were also studied. Results were expressed in the form of mean and standard deviation. A p-value <0.05 considered significant. Results: In TURP group, statistically significant changes were seen in serum sodium, potassium, LDH and free calcium ions. There was no change in acid base status of patients. In PCNL group, statistically significant changes were seen in serum sodium, LDH, free calcium ion and acid base status. It was observed that some of these changes persisted even 24 hours, postoperatively. However, despite the above changes, the haemodynamic parameters remained within normal limits. Conclusion: Changes in serum sodium, serum potassium and free calcium ion during TURP and PCNL were consistent findings which implies fluid absorption. These changes persist upto 24 hours postoperatively. The monitoring of these parameters in postoperative period should be continued especially in patients suspected to develop or having TURP syndrome.

Keywords

• hyperkalemia
• hypocalcaemia
• hyponatremia
• prostectomy lithotripsy