Sorbitol-mannitol solution for urological electrosurgical resection - A safer fluid than glycine 1.5%

Objective: To evaluate the safety and suitability of sorbitol-mannitol solution (Purisole(R), Fresenius, Germany) as a fluid for irrigation during electrosurgical resection of prostate (TURP). Patients and Methods: 120 sequential patients undergoing TURF were studied. Serum electrolytes were measured before and the day after surgery. Time and weight of resection were recorded. Use of blood transfusion was recorded. Results: There were no adverse effects attributable to the use of the irrigant. There were no technical, electrical or instrument problems. None of the surgeons had a ny difficulties with clarity of view during resection when bleeding was light. There was no significant change in any of the serum electrolytes between pre-operative and postoperative values. No patient developed significant postoperative hyponatraemia or the 'TUR syndrome'. Conclusions: Purisole (sorbitol-mannitol) solution is entirely satisfactory as an irrigant for electrosurgical resection and in the present study there were no measurable changes in patients' electrolytes around the time of surgery. What small changes occurred indicate there is an overall mild dehydration effect through the process of surgery, which may be in part attributable to irrigant, but this change was small and does not reach either clinical or statistical significance. Purisole offers theoretical advantages over glycine solution and there are no obvious disadvantages. The authors would thereby recommend it in preference to glycine.