A Comparison of Hemodynamic and Biochemical Changes Between Normal Saline Irrigation and Glycine Irrigation in Transurethral Resection of Prostate

Abstract

Background: Transurethral resection of prostate (TURP) is the most commonly performed surgery for benign prostatic hyperplasia (BPH). Monopolar TURP using 1.5% glycine as irrigation fluid is the commonest choice. However, recently biploar TURP is introduced which allows 0.9% normal saline to be used as irrigation. This prospective study was to compare the hemodynamic and biochemical changes between 0.9% normal saline irrigation and 1.5% glycine irrigation in TURP.
Material and methods: It is a randomized study, carried out on 114 patients, divided into two groups of 57 patients each. Group S underwent bipolar TURP using 0.9% normal saline and Group G underwent monopolar TURP using 1.5% glycine under spinal anaesthesia. The changes in hemodynamic and biochemical parameters in both groups were noted.
Results: The hemodynamic parameters (mean HR and MAP) in both groups gradually declined at 15mins and 30 mins and then increased in postoperative period. Regarding biochemical parameters, both haemoglobin and hematocrit showed gradual fall in both groups and statistically significant difference was only at immediate postoperative period. Serum sodium, potassium and osmolarity also showed gradual fall in both groups throughout the procedure. However, only the decrease in serum sodium concentration was statistically significant at immediate postop and 2hr post-op period between the two groups. (p value 0.037 and 0.008 respectively).
Conclusion: The changes in hemodynamic and biochemical parameters were equivalent in both groups except serum sodium concentration, which showed significantly less drop in 0.9% normal saline group than 1.5% glycine group.