Metabolic acidosis with hemodilution due to massive absorption of normal saline as bladder irrigation fluid following holmium laser enucleation of prostate

Holmium laser enucleation of prostate (HoLEP) is being performed with increasing frequency as a minimally invasive alternative to transurethral resection of the prostate (TURP) for the surgical management of benign prostatic hyperplasia (BPH). HoLEP offers the advantage of use of normal saline for irrigation, instead of glycine which is utilized in TURP, decreasing the likelihood of fluid absorption and effects on serum electrolytes. We describe a patient who underwent HoLEP for BPH and subsequently developed non-ion gap metabolic acidosis and hemodilution associated with volume overload.

Journal of anesthesia. 2016 [Epub ahead of print]

Sarah E Dodd, Christopher J Jankowski, Amy E Krambeck, Bhargavi Gali

Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Department of Urology, Mayo Clinic, Rochester, MN, USA., Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. .

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