Canadian Journal of Anesthesia, Vol 1, 59-66, Copyright © 1954 by Canadian Anesthesiologists' Society

Complications Arising during Transurethral Resection of the Prostate

¹ St. Boniface Anaesthetic Clinic and St. Boniface Hospital, St. Boniface, Manitoba

We believe that hemolysis during a transurethral resection of the prostate is one of the factors involved in the production of a lower nephron nephrosis postoperatively. The other factors are hemorrhage, shock and previously diseased kidneys. These latter three factors may be minimized by obvious means and the factor of intravascular hemolysis diminished by the use of an isotonic irrigating fluid, or if water is being used, by the early recognition and treatment of hemolysis. It is true that isotonic solutions, by virtue of their non-hemolyzing properties, do interfere somewhat with vision within the bladder, but it requires very little change in surgical technique to overcome this obstacle.

In our series hemolysis occurred a total of 57 times, and in 50% of the cases signs and symptoms suggestive of hemolysis occurred.

Signs and symptoms suggestive of hemolysis are, a sudden feeling of weakness or tiredness, chills and/or a clammy skin, bronchospasm, a rising blood pressure usually accompanied by a slowing of the pulse rate.

By following the principle of early recognition and treatment there were, in our series of 191 cases, no instance of postoperative anuria, nor was lower nephron nephrosis a feature in any of our postoperative deaths.