The Use of Ethanol-Tagged Mannitol in Transurethral Resection of the Prostate Does not Alter the Bleeding Time in Patients who Absorb Irrigation Fluid

Abstract

To increase patient safety ethanol tagging of irrigation fluid is practised at several hospitals in Sweden to detect absorption of irrigation fluid during transurethral prostatic resection. Using this method it is found that almost half of the patients undergoing transurethral prostatic resections absorb irrigation fluid to some extent. Patients absorbing irrigation fluid bleed more than others. The phenomenon has been blamed on the open veins and sinusoides. Further, these patients are older, have larger prostates and longer operating times. To exclude an effect of ethanol-tagged irrigation fluid on the skin bleeding time this was measured before and after the operation in 57 patients. In 18 (32%) 160–1760 ml of irrigation fluid was absorbed, and in 9 patients over 480 ml. No difference in skin bleeding time emerged between absorbers and non-absorbers, and absorbers showed no differences in bleeding time between preoperative and postoperative values. There was a slight but insignificant decrease in the skin bleeding time after the operation in both absorbers and non-absorbers.

Keywords:

• transurethral resection of the prostate
• irrigation fluid absorption
• bleeding time
• ethanol monitoring