Extravascular absorption of irrigating fluid during TURP. The role of transmural bladder pressure as the driving pressure gradient. 1990

J O Hultén, and G S Sundström
Department of Surgery and Urology, County Hospital, Piteå, Sweden.

The critical intravesical pressure range for extravascular absorption of irrigating fluid (EVA) during transurethral resection of the prostate (TURP) is determined by the pressure in the perivesical tissue. This means that the transmural bladder pressure (detrusor pressure), calculated by deducting perivesical pressure from intravesical pressure during cystometry, is the pressure gradient behind EVA. The transmural pressure in 6 patients undergoing TURP has been studied both before and during epidural anaesthesia, using both conventional medium-fast fill cystometry and "free-flow" cystometry through the resectoscope. Epidural block does not influence the transmural pressure response on filling the bladder and neither does the type of infusion. A positive transmural pressure, and thereby a pressure gradient for EVA, exists already during the very early phase of bladder filling. Incomplete perforation of the prostatic capsule and clotting, as well as the accumulation of irrigating fluid in the perivesical tissue, probably moderate the rate of absorption.

UI MeSH Term Description Entries
D007507 Therapeutic Irrigation The washing of a body cavity or surface by flowing water or solution for therapy or diagnosis. Douching,Lavage,Douchings,Irrigation, Therapeutic,Irrigations, Therapeutic,Lavages,Therapeutic Irrigations
D008297 Male Males
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D011467 Prostate A gland in males that surrounds the neck of the URINARY BLADDER and the URETHRA. It secretes a substance that liquefies coagulated semen. It is situated in the pelvic cavity behind the lower part of the PUBIC SYMPHYSIS, above the deep layer of the triangular ligament, and rests upon the RECTUM. Prostates
D011468 Prostatectomy Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (TRANSURETHRAL RESECTION OF PROSTATE). Prostatectomy, Retropubic,Prostatectomy, Suprapubic,Prostatectomies,Prostatectomies, Retropubic,Prostatectomies, Suprapubic,Retropubic Prostatectomies,Retropubic Prostatectomy,Suprapubic Prostatectomies,Suprapubic Prostatectomy
D011470 Prostatic Hyperplasia Increase in constituent cells in the PROSTATE, leading to enlargement of the organ (hypertrophy) and adverse impact on the lower urinary tract function. This can be caused by increased rate of cell proliferation, reduced rate of cell death, or both. Adenoma, Prostatic,Benign Prostatic Hyperplasia,Prostatic Adenoma,Prostatic Hyperplasia, Benign,Prostatic Hypertrophy,Prostatic Hypertrophy, Benign,Adenomas, Prostatic,Benign Prostatic Hyperplasias,Benign Prostatic Hypertrophy,Hyperplasia, Benign Prostatic,Hyperplasia, Prostatic,Hyperplasias, Benign Prostatic,Hypertrophies, Prostatic,Hypertrophy, Benign Prostatic,Hypertrophy, Prostatic,Prostatic Adenomas,Prostatic Hyperplasias, Benign,Prostatic Hypertrophies
D001743 Urinary Bladder A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION. Bladder,Bladder Detrusor Muscle,Detrusor Urinae,Bladder Detrusor Muscles,Bladder, Urinary,Detrusor Muscle, Bladder,Detrusor Muscles, Bladder
D005998 Glycine A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. Aminoacetic Acid,Glycine, Monopotassium Salt,Glycine Carbonate (1:1), Monosodium Salt,Glycine Carbonate (2:1), Monolithium Salt,Glycine Carbonate (2:1), Monopotassium Salt,Glycine Carbonate (2:1), Monosodium Salt,Glycine Hydrochloride,Glycine Hydrochloride (2:1),Glycine Phosphate,Glycine Phosphate (1:1),Glycine Sulfate (3:1),Glycine, Calcium Salt,Glycine, Calcium Salt (2:1),Glycine, Cobalt Salt,Glycine, Copper Salt,Glycine, Monoammonium Salt,Glycine, Monosodium Salt,Glycine, Sodium Hydrogen Carbonate,Acid, Aminoacetic,Calcium Salt Glycine,Cobalt Salt Glycine,Copper Salt Glycine,Hydrochloride, Glycine,Monoammonium Salt Glycine,Monopotassium Salt Glycine,Monosodium Salt Glycine,Phosphate, Glycine,Salt Glycine, Monoammonium,Salt Glycine, Monopotassium,Salt Glycine, Monosodium
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000042 Absorption The physical or physiological processes by which substances, tissue, cells, etc. take up or take in other substances or energy.

Related Publications

J O Hultén, and G S Sundström
July 1992, Urology,
J O Hultén, and G S Sundström
April 1992, Urology,
J O Hultén, and G S Sundström
March 1993, Urology,
J O Hultén, and G S Sundström
January 1991, Scandinavian journal of urology and nephrology. Supplementum,
J O Hultén, and G S Sundström
January 1986, Scandinavian journal of urology and nephrology,
J O Hultén, and G S Sundström
November 1993, British journal of urology,
J O Hultén, and G S Sundström
January 1993, Scandinavian journal of urology and nephrology,
J O Hultén, and G S Sundström
April 2000, Scandinavian journal of urology and nephrology,
J O Hultén, and G S Sundström
March 1999, Acta anaesthesiologica Scandinavica,
Copied contents to your clipboard!