大分泌尿器科病院におけるTUR732例の経験および潅流液使用量による血清Na値の簡易補正法に関する検討

Abstract

Clinical results of 732 cases of transurethral resections (TUR) at the Ohita Urologic Hospital for the 8 years, from 1974 to 1982, are evaluated and analyzed. They consisted of 591 TUR's for benign prostatic hypertrophy, 45 for cancer of the prostate, 64 for bladder tumors and 32 for biopsies of various sorts. The weight of the tissue resected was 17.8 (2-92 g) grams on the average in benign prostatic hypertrophy, 17.5 g in cancer of the prostate and 4.0 g in bladder tumor cases. The time needed for the resecting procedure was 42.2 minutes on the average in prostatic hypertrophy, 40.8 minutes in cancer of the prostate and 26.6 minutes in bladder tumor cases. The major operative and post-operative complications consisted of 36 epididymites, 14 massive postoperative hemorrhages, 14 strictures of urethra, 12 perforations of prostatic capsule and 2 post operative stress incontinences. It is well known that the irrigating fluid used during TUR of the prostate is frequently absorbed into the patient's body in large amounts. Approximately one-half correction of the diluted serum sodium level by giving 20 ml (40 mEq) of 10% NaCI solution intravenously at each 10 liters of isotonic irrigating fluid during the resecting procedure is helpful in preventing the postoperative hyponatremic syndrome.