irrigation during TURP

shodobe · May 7, 2005

Neither where I work. Our Urologist use "glycine" to irrigate during a TURP. We don't do as many nowadays because they use other methods and they prefer to do radicals instead.

Marie_LPN, RN, LPN, RN · May 7, 2005

Normal Saline is what we use, the 2 L bottles.

Ali G. · May 7, 2005

Do you know if sterile water is used to irrigate the bladder during a TURP or is it Normal Saline?

We use Sorbitol Mannitol IV while doing the TURP and then use H2O when using the evacuator to get the tissue out

shodobe · May 7, 2005

As you can see, there is no set standard among Urologist. It is whatever they were taught during residency. Got to go and do a Lap Chole. Mike

grimmy, RN · May 7, 2005

ditto with mike. each urologist does their own thing, but most say sterile water is fine. depends on other issues with the patient, too.

stevierae · May 8, 2005

ditto with mike. each urologist does their own thing, but most say sterile water is fine. depends on other issues with the patient, too.

wherever i have worked, we have always used glycine or sorbitol throughout the turp as long as the resectoscope (with the knife or loop of choice, connected to the cautery) is being used. you have to use an electrolyte containing solution to conduct electricity, i thought, or at least conduct it better, right? we usually switch to water only after the prostate is completely resected (all pieces scoped up and put in the specimen container) and all the bleeding stopped--then, the foley put in and irrigation connected, which is usually h20, but i am thinking ns would be ok at this point, too. i can't recall ever using ns for irrigation during the use of a resectoscope during a turp, although i'm not sure why, since it's also an electrolyte solution, and thus conductive.

i've never even seen a laser turp, so that could be a whole different ballgame, for all i know.

Seelo · May 8, 2005

ditto with mike. each urologist does their own thing, but most say sterile water is fine. depends on other issues with the patient, too.

so eventhough sterile water is hypotonic and hemolytic, it is still okay for use in irrigation.....just been reading a lot of articles re: normal saline vs sterile water use in irrigation of bladder and it seems the literature is controversial....seems as if a lot of urologists use either or.....read something about being able to visualize the bladder better with sterile water....have you heard this as well?

mcmike55 · May 8, 2005

Our uro guys use (used) Sorbitol/Manitol in 3 liter bags for TUR-P's.

We would normally hang Glycine solution post op, run a continuous bladder irrigation thru a 3 way foley.

For just plain cystos, our older doc uses water, the newer guys run N.S.

For TUR-BT's, both use water.

I say used, because most of the time, we now use a green light yag laser, used to be called a Niagra. Lost the name, some sort of brand name complication with another company I think.

During those, we use just plain water. Rarely use a 3 way foley any more. With the laser blood loss is almost nil.

I agree, it seems what the doc is used to. Experience and training you know.

Mike

stevierae · May 9, 2005

Our uro guys use (used) Sorbitol/Manitol in 3 liter bags for TUR-P's.
We would normally hang Glycine solution post op, run a continuous bladder irrigation thru a 3 way foley.
For just plain cystos, our older doc uses water, the newer guys run N.S.
For TUR-BT's, both use water.
I say used, because most of the time, we now use a green light yag laser, used to be called a Niagra. Lost the name, some sort of brand name complication with another company I think.
During those, we use just plain water. Rarely use a 3 way foley any more. With the laser blood loss is almost nil.
I agree, it seems what the doc is used to. Experience and training you know.
Mike

Mike, with the laser......is the prostate vaporized, so that there is no specimen? Is there still the smell that was classic of the old-fashioned TURPs?