Glycine 1.0% versus glycine 1.5% as irrigating fluid during transurethral resection of the prostate

OBJECTIVE: To evaluate the potential benefits of reducing the glycine concentration from 1.5% to 1.0% in the irrigating fluid used during transurethral resection of the prostate (TURP) when 1% ethanol is used as the tracer of absorption. PATIENTS AND METHODS: The effect of 1% ethanol on the tendency for blood to haemolyse was tested in vitro and the optical condition of the irrigating fluids were studied during 10 TURPs. The breath ethanol level was monitored during 423 operations where these fluids were used in a randomized double-blind study. The incidence of 13 symptoms was recorded in the 77 patients who absorbed irrigating fluid. RESULTS: Ethanol slightly lowered the tendency for blood to haemolyse. Reducing the glycine concentration did not alter the optical conditions during TURP. The incidence of symptoms increased significantly as more glycine solution was absorbed, arterial hypotension and nausea being the most usual. Bradycardia, prickling skin sensations and feelings of uneasiness were less common when 1.0% glycine was used, but the choice of irrigating fluid had no effect on the total incidence of symptoms. CONCLUSION: We found no clear advantage in lowering the glycine concentration of the irrigating fluid used during TURP.