Absorption of irrigation fluid during XPS    GreenLight laser vaporization of the prostate: results from a prospective breath XXXX monitoring study.

@entity1 @entity3157 @entity751 @entity2865 @entity1068
PURPOSE: To assess whether and to what extent irrigation fluid absorption occurs during laser vaporization (LV) of the prostate using the 180  W XPS    GreenLight laser. METHODS: This prospective investigation was performed in a tertiary care center with a consecutive series of @entity1 undergoing 180  W LV of the prostate. Intraoperative irrigation was performed with isotonic saline containing 1  % @entity1068 . The volume of irrigation fluid absorption was calculated from periodically performed breath @entity1068 measurements during LV. Additionally, intraoperative changes in biochemical and hematological blood parameters were assessed. RESULTS: Positive breath @entity1068 tests were detectable in 22 of 54 @entity1 . The median absorption volume in these @entity1 was 950  ml (range 208-4579  ml). Ten @entity1 absorbed more than 2000  ml. Absorbers had smaller prostates, more capsular perforations and injuries to venous sinuses, and more total energy was applied with higher output power. Five @entity1 had transient symptoms potentially related to fluid absorption. A significant drop in hemoglobin, hematocrit, venous pH and @entity3157 and an increase in @entity2865 were detectable in the absorber group. These changes were significantly different in the non-absorber group. CONCLUSIONS: Absorption of irrigation fluid did occur in a relevant proportion of @entity1 undergoing XPS    GreenLight LV. High-volume absorption (>= 2000  ml), which might be clinically relevant, was detectable in almost 20  % of all procedures. Absorption of saline irrigation fluid does not result in a classical @entity751 , but fluid and @entity2865 overload can lead to serious complications, particularly in cardiovascular high-risk @entity1 . Thus, @entity1 with symptoms potentially related to fluid absorption should be monitored carefully.
