Absence of Lactate Accumulation on Transurethral Resection of the Prostate Using 2.5% Sorbitol Solution As An Irrigating Fluid

Abstract

19 patients with benign hyperplasia of the prostate were studied. During transurethral resection of the prostate, 2.5% sorbitol solution was used as an irrigating fluid. Blood samples were taken preoperatively, immediately postoperatively, and 60 and 120 min postoperatively. Samples were analysed for sorbitol metabolites (fructose, glucose, lactate and pyruvate) and inorganic phosphate. The series was divided into two groups, one with low absorption and one with high absorption of irrigating fluid. The limit for the plasma sorbitol concentration immediately postoperatively, dividing the groups, was 1.0 mmol/1, corresponding to an absorbed fluid volume of about 0.1 1. There was a slight increase in lactate and a significant decrease in pyruvate in the blood in both groups postoperatively. Blood fructose was zero in the group with low absorption of irrigating fluid whereas there was a slight increase in the group with high absorption, with a maximum of 0.53 mmol fructose/1. Blood glucose did not show any significant changes postoperatively. Inorganic phosphate in serum showed a significant decrease postoperatively in both groups. There were no significant differences between the groups at the various postoperative sampling times with regard to lactate, pyruvate, glucose or inorganic phosphate in the blood. Thus, we did not observe any accumulation of lactate in the blood when using 2.5% sorbitol solution as an irrigating fluid with absorbed fluid volumes up to 1 litre (corresponding to 25 g sorbitol).

Key words:

• Transurethral resection of the prostate
• Sorbitol solution
• Sorbitol metabolism
• Blood fructose
• Lactate
• Pyruvate
• Serum inorganic phosphate