Changes in serum Na+ and blood hemoglobin levels during three types of transurethral procedures for the treatment of benign prostatic hypertrophy

Takashi Akata, Hayashi Yoshimura, Yuko Matsumae, Hiroaki Shiokawa, Tomoko Fukumoto, Tadashi Kandabashi, Taiki Yamaji, Shosuke Takahashi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Transurethral holmium YAG laser resection of the prostate (HoLR-P) and transurethral electrovaporization of the prostate (TUV-P) have recently received increasing attention as an effective minimally invasive approach for the treatment of prostatic hypertrophy. However, less information is available regarding the intraoperative changes in the serum Na+ and blood hemoglobin levels during either HoLR-P or TUV-P. Methods: Intraoperative changes in serum Na+ and blood hemoglobin levels were investigated in 17 patients undergoing transurethral resection of the prostate (TUR-P, n = 7), HoLR-P (n = 7) or TUV-P (n = 3). The 3% D-sorbitol solution was used as the irrigating fluid in all the patients. Results: In three patients, severe hyponatremia (118-123 mEq · l-1) developed abruptly (≤15 min) at various time points during TUR-P with (n = 1) or without (n=2) cystostomy. However, no clinical symptoms were observed after development of the hyponatremia in those awake patients. No large (>10mEq · l -1) decreases in the Na+ level were observed in any of the patients undergoing HoLR-P or TUV-P. In patients undergoing TUR-P and HoLR-P, percent changes in serum Na+ level significantly correlated with those in blood hemoglobin level, but not with the resection time; the slopes were significantly larger than unity. Conclusions: The TUR syndrome is less likely to occur during HoLR-P or TUV-P. During TUR-P, the onset of severe hyponatremia appears to be unpredictable, and may not necessarily be accompanied by clinical symptoms. Frequent measurements of the serum Na+ level appear essential for early detection of severe hyponatremia.

Original languageEnglish
Pages (from-to)638-644
Number of pages7
JournalJapanese Journal of Anesthesiology
Volume53
Issue number6
Publication statusPublished - Jun 1 2004

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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