scholarly journals A Prospective Study on the Degree of Hyponatremia in Transurethral Resection of Prostate

2021 ◽  
pp. 639-644
Author(s):  
Maryam Fatima ◽  
Zainab Ali ◽  
Zubia Zafar
Keyword(s):  
Transurethral Resection ◽  
Transurethral Resection Of Prostate ◽  
Sodium Potassium ◽  
High Incidence ◽  
Turp Syndrome ◽  
Mean Size ◽  
The Mean ◽  
A Prospective Study ◽  
Duration Of Operation

Background: Systemic uptake of hypotonic fluid during irrigation performed at the time of Transurethral Resection of the Prostate (TURP) may cause electrolyte changes including sodium, potassium and calcium. The present study was aimed to assess the degree of sodium changes during Transurethral Resection of Prostate (TURP). Methods: 50 males aged 54 to 86 years, presented for TURP, were enrolled in the study with ASA classification of I to IV grades. Glycine 1.5% was used with height of irrigation kept at 60 cm. One day preoperatively and one hour postoperative, levels of serum sodium were measured for all the patients. Results: Spinal anaesthesia was given in 31 patients, whereas 19 patients were managed under general anaesthesia, with mean duration time being 72.42 ± 24.77min. The mean size of the resected prostate was 54.82 ± 25.04g. 58% patients developed mild hyponatremia, 4% had asymptomatic moderate hyponatremia and no patient developed severe hyponatremia or TURP Syndrome. The systemic diseases like hypertension, DM, or IHD found to be insignificant. Conclusion: TURP was associated with a high incidence of asymptomatic mild hyponatremia. Duration of operation was one of the most important factors.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

scholarly journals Laparoscopic Versus Open Appendicectomy: A Comparison of Primary Outcome

2015 ◽  
Vol 9 (2) ◽  
pp. 84-87
Author(s):  
Md Mazedur Rahman ◽  
Md Siddiqur Rahman ◽  
Guljar Ahmed ◽  
Md Mushfiqur Rahman ◽  
Md Zohirul Islam Miah ◽  
...  
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Early Discharge ◽  
Early Return ◽  
The Mean ◽  
Group 2 ◽  
A Prospective Study ◽  
Duration Of Operation ◽  
Laparoscopic Versus Open Appendectomy

Currently, laparoscopic appendectomy is widely practiced for the management of acute appendicitis. It is not clear whether open or laparoscopic appendectomy is more appropriate. Our aim was to compare the safety and the advantages of laparoscopic versus open appendectomy in a prospective study. 102 patients were participated in this study. The group 1 patients were subjected to laparoscopic appendectomy [LA], whereas the group 2 patients were subjected to open appendectomy [OA]. 46 patients included in LA group and 54 patients in OA group. The mean operative time for LA and OA was 84.4 (45-220) minutes and 59 (30-180) minutes respectively. Although LA was associated with a shorter hospital stay [LA-3.5 days versus OA-5 days] but duration of operation is prolong in LA than OA and the postoperative wound infection is significantly higher in OA than LA. LA is safe and superior to OA in respect to an early discharge, lesser postoperative pain; decreased post operative wound infection, early return to work and a better cosmetic scar.Faridpur Med. Coll. J. 2014;9(2): 84-87

scholarly journals Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

2021 ◽  
Vol 12 (8) ◽  
pp. 60-64
Author(s):  
Rajesh Kumar Maurya ◽  
Vinay Kumar ◽  
Kumar Vineet
Keyword(s):  
Energy Source ◽  
Transurethral Resection ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
North India ◽  
Transurethral Resection Of Prostate ◽  
Care Hospital ◽  
Operative Morbidity ◽  
Bipolar Energy ◽  
Turp Syndrome

Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection. Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate. Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source. Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group. Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

scholarly journals A Prospective Study to Assess the Effectiveness of Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy for Proximal Ureteral Calculi Between Sizes 5 to 10 mm

2020 ◽  
Vol 19 (2) ◽  
pp. 65-69
Author(s):  
Bikash Bahadur Rayamajhi ◽  
Anjan Khadka ◽  
Narayan Thapa
Keyword(s):  
Ureteral Calculi ◽  
National Guidelines ◽  
Female Ratio ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Mean Size ◽  
Surgical Options ◽  
The Mean ◽  
Enhanced Computed Tomography ◽  
A Prospective Study

Introduction: There are various international guidelines for the surgical treatment of upper ureteral calculi. For upper ureteral stone of less than 10 mm size, ESWL and URS are regarded as first line treatment. However, there is lack of national guidelines for appropriate surgical options for such stone in our settings. Methods: The study was prospective comparative type involving 100 patients who were divided into ESWL and URS groups comprising 50 patients in each. ESWL and URS were performed after confirmation of stone size with ultrasonography and non-contrast enhanced computed tomography. All patients underwent X-ray KUB at one week and six weeks post procedure for confirmation of stone clearance. Those with residual calculi of size < 5 mm were considered stone free. Statistical analysis was done using Graph pad prism version 6. Results: The mean age of patients in ESWL and URS groups were 41.28 ± 15.3 years and 42.84 ± 16.1 years respectively. The male to female ratio was higher in ESWL group. The mean size of the stone pre ESWL was 8.58 mm and pre URS was 8.44 mm. The percentage of stone clearance at one week and six weeks for ESWL was 56% and 90% respectively whereas for URS, it was more than 90% at both one week and six weeks. The complications were higher with URS (20%) than ESWL (8%). Conclusions: The ESWL and URS are equally effective in stone clearance. The duration is longer with ESWL and the complications were more in URS group.

Safety and efficacy of intraoperative administration of intravenous tranexamic acid in transurethral resection of prostate: A double-blind, randomised, placebo-controlled trial

2019 ◽  
Vol 13 (2) ◽  
pp. 125-131
Author(s):  
Behrooz Karkhanei ◽  
Seyyed Habibollah Musavi-Bahar ◽  
Masume Bayat ◽  
Kaveh Kaseb ◽  
Haress Rezaee ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Transurethral Resection ◽  
Controlled Trial ◽  
Operation Time ◽  
Control Group ◽  
Transurethral Resection Of Prostate ◽  
Prostate Weight ◽  
The Mean ◽  
And Control ◽  
Surgeon Satisfaction

Purpose: The purpose of this article is to evaluate and compare the effect of intravenous tranexamic acid (TXA) with placebo on haemorrhage and quality of vision during and post-transurethral resection of the prostate (TURP). Methods: For nine months (September 2016 until June 2017), a randomised clinical trial was conducted with 70 patients, age 50–80 years, who were included in the study according to inclusion criteria (patients who required surgical intervention because of benign prostatic hyperplasia, prostate weight (<100 cc), American Society of Anesthesiologists score ⩽II, etc.) and enrolled randomly one to one in two study groups, and who underwent TURP in Shahid Beheshti Hospital of Hamadan University of Medical Sciences by a single surgeon. Interventions: The study group participants received 500 mg TXA in 500 ml ringer serum (concentration of 1 mg/ml, infusion rate 100 mg/min, maximum dose of 15 mg/kg), whereas the control group received only ringer serum during surgery. The results were then compared for the variables operation time, amount of haematocrit (HCT)-haemoglobin (Hb) reduction following surgery and surgeon satisfaction. Results: Both groups had no difference in age, weight and prostate weight. Surgeon satisfaction was evaluated at the end of the operation. The frequency of high satisfaction in case and control groups was 74.3% and 8.65%, whereas low satisfaction was 0% and 42.69%, respectively ( p < 0.05). The mean time of operation was 53.57±16.43 vs 120.71±47.76 minutes in the case and control group, respectively ( p < 0.05). The mean HCT-Hb decrease ( p = 0.00) and the amount of infused volume before and after the operation ( p = 0.03) between both groups were significantly different. None of the patients experienced TXA side effects. Conclusions: Intravenous TXA can prevent haemorrhage and higher Hb and HCT reduction following TURP, shortening the operation time and improving surgeon vision during TURP. Level of evidence: 1b

scholarly journals Incidence, clinical manifestations and outcome of TUR (transurethral resection) syndrome in patients undergoing TURP under spinal anaesthesia: results from clinical observations in a cohort of 50 patients at a tertiary care centre in North India

2017 ◽  
Vol 5 (1) ◽  
pp. 243
Author(s):  
Christina George ◽  
Parvez David Haque ◽  
Kim J. Mammen
Keyword(s):  
Spinal Anaesthesia ◽  
Serum Sodium ◽  
Transurethral Resection ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
North India ◽  
Spinal Block ◽  
Transurethral Resection Of Prostate ◽  
Turp Syndrome

Background: ‘TUR syndrome’ is clinically detectable in 2% of patients undergoing an otherwise safe operation. Currently, spinal anaesthesia is the most widely anaesthetic technique for TURP as it is easier to detect signs of TUR syndrome in an awake patient. This study aimed at looking at the clinical spectrum and outcomes of TUR syndrome in patients undergoing TURP under spinal anaesthesia.Methods: This clinical study was conducted over a period of 6 months in the departments of anesthesiology and urology at the Christian medical college and hospital Ludhiana in a cohort of 50 male patients electively admitted for TURP under spinal block belonging to ASA I or II groups. Patients received intermittent irrigation with 1.5% glycine, and monitored for TUR symptoms and electrolyte estimations perioperatively.Results: In our study the incidence of TURP syndrome was 10 %. Under spinal block clinical manifestations along with serum sodium values monitored perioperatively helped diagnose and manage the patients. All patients successfully completed resection, with no mortality related to TURP syndrome.Conclusions: In patients undergoing transurethral resection of prostate under spinal anaesthesia, monitoring clinical symptoms for the rare TURP syndrome and additional serum sodium levels act as an adjunct in diagnosis. In both situations diagnosis and early intervention prevents extreme neurological symptoms and reduces mortality.

scholarly journals Prospective observational study on caudal epidural block for transurethral resection of prostate in patients with comorbidities

2016 ◽  
Vol 3 (2) ◽  
pp. 74-79
Author(s):  
Bandana Paudel ◽  
Sumitra Paudel ◽  
Chitta Ranjan Das
Keyword(s):  
Elderly Patients ◽  
Prospective Study ◽  
Transurethral Resection ◽  
Epidural Block ◽  
Transurethral Resection Of Prostate ◽  
Caudal Epidural Block ◽  
Comorbid Diseases ◽  
American Society ◽  
A Prospective Study ◽  
Caudal Epidural

Background: The most important goal of anaesthesia for geriatric patients with comorbid diseases is to maintain normal homoeostasis of different systems during and after surgery. This prospective study was conducted to evaluate the success rate and associated complications of the caudal epidural block for transurethral resection of prostate in elderly patients with comorbid diseases.Methods: This is a prospective study of a cohort of 100 elderly patients posted for transurethral resection of prostate with comorbid diseases belonging to American Society of anaesthesiologists physical status II, III and IV over a period of 1 year from April 2015 to April 2016. Standard recommended technique for caudal epidural block was followed. Time of onset, spread, duration of analgesia, intensity of block, complications, and unwanted effects were noted.Results: The mean age was 73.5+-7.69. Eighty-two percent patients belonged to ASA III and IV grade. The majority (87%) had excellent to a good quality of anaesthesia with no motor block. 83% of patients had the onset of analgesia between 5-15 minutes and 78% had a duration between 90-130 minutes. Three patients had patchy analgesia and they were considered as a failure. No death was encountered in the study.Conclusion: Caudal epidural block is a safe, effective anaesthetic technique for transurethral resection of the prostate in elderly with comorbid diseases of other systems. 

scholarly journals Body mass index: different nutritional status according to WHO, OPAS and Lipschitz classifications in gastrointestinal cancer patients

2012 ◽  
Vol 49 (2) ◽  
pp. 169-171 ◽  
Author(s):  
Katia Barao ◽  
Nora Manoukian Forones
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Gastrointestinal Cancer ◽  
Low Cost ◽  
The Body ◽  
Common Marker ◽  
The Mean ◽  
A Prospective Study

CONTEXT: The body mass index (BMI) is the most common marker used on diagnoses of the nutritional status. The great advantage of this index is the easy way to measure, the low cost, the good correlation with the fat mass and the association to morbidity and mortality. OBJECTIVE: To compare the BMI differences according to the WHO, OPAS and Lipschitz classification. METHODS: A prospective study on 352 patients with esophageal, gastric or colorectal cancer was done. The BMI was calculated and analyzed by the classification of WHO, Lipschitz and OPAS. RESULTS: The mean age was 62.1 ± 12.4 years and 59% of them had more than 59 years. The BMI had not difference between the genders in patients <59 years (P = 0.75), but over 59 years the BMI was higher in women (P<0.01). The percentage of undernourished was 7%, 18% and 21% (P<0.01) by WHO, Lipschitz and OPAS, respectively. The overweight/obesity was also different among the various classifications (P<0.01). CONCLUSIONS: Most of the patients with gastrointestinal cancer had more than 65 years. A different cut off must be used for this patients, because undernourished patients may be wrongly considered well nourished.

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