Comparision of Effectiveness of Irrigation Fluid Mannitol 5% with That of Glycine 1.5% in Preventing Post Turp Hyponatremia

INTRODUCTION: Transurethral resection of the prostate (TURP) requires the use of an irrigating fluid to remove blood and debris to visualize the operating area. Glycine solution is the most commonly used irrigant & has been used in TURP for > 50years. There is now increasing evidence, highlighting the toxicity of glycine 1.5% solution when absorbed during TURP causing TUR syndrome. On the other hand the severity of the syndrome can probably be modified by using mannitol 5% instead of the most widely used glycine 1.5% as an irrigating fluid. MATERIALS AND METHODS: STUDY DESIGN: Quasi-experimental study PLACE OF STUDY: Urology department at Liaquat National Hospital, Karachi. DURATION OF STUDY: Six months from 11.05.2006 to 10.11.2006. SAMPLE SIZE: 50 patients in each group. SAMPLING TECHNIQUE: Non-probability, purposive SAMPLE SELECTION: Inclusion Criteria: All patients undergoing transurethral resection of prostate. Exclusion Criteria: 1. Patients with cardiac failure. 2.Patients with COPD & pulmonary edema. 3. Patients with hypoprotienemia 4. Patients with chronic renal failure. 5. Patients with hematological disorders including bleeding diathesis. 6.P a t i e n t s with hyponatremia. 7. Patients with severe lower urinary tract infection. RESULTS: The study was carried out in 100 patients divided into two groups, both groups underwent TURP. Group-A included 50 patients in which mannitol 5% used as an irrigant. Group-B also included 50 patients treated with Glycine 1.5%. No significant change noted regarding post operative serum sodium level. Only three patients out of fifty in group “B” developed visual disturbances. One patient developed tachycardia in group “A” while two patients developed tachycardia in group “B” & three patients needed ICU monitoring in group “B”. CONCLUSION: In conclusion Mannitol 5% proved better irrigation solution as compared to Glycine 1.5% for Trans urethral resection of Prostate in prevention of post TUR syndrome due to causes other than serum sodium level.