Abstract
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.
Similar content being viewed by others
References
Seki N, Tatsugami K, Naito S. Holmium laser enucleation of the prostate: comparison of outcomes according to prostate size in 97 Japanese patients. J Endourol. 2007;21:192–6.
Bapat SA, Mishra GC. Stem cell pharmacogenomics. Curr Top Med Chem. 2004;4:1371–83.
Shah HN, Kausik V, Hegde S, Shah JN, Bansal MB. Evaluation of fluid absorption during holmium laser enucleation of prostate by breath ethanol technique. J Urol. 2006;175:537–40.
Aho TF. Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery. Ther Adv Urol. 2013;5:245–53.
Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) century. Am J Clin Exp Urol. 2015;3:36–42.
Hermanns T, Fankhauser CD, Hefermehl LJ, Kranzbuhler B, Wong LM, Capol JC, Zimmermann M, Sulser T, Muller A. Prospective evaluation of irrigation fluid absorption during pure transurethral bipolar plasma vaporisation of the prostate using expired-breath ethanol measurements. BJU Int. 2013;112:647–54.
Hermanns T, Grossmann NC, Wettstein MS, Fankhauser CD, Capol JC, Poyet C, Hefermehl LJ, Zimmermann M, Sulser T, Muller A. Absorption of irrigation fluid occurs frequently during high power 532 nm laser vaporization of the prostate. J Urol. 2015;193:211–6.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Dodd, S.E., Jankowski, C.J., Krambeck, A.E. et al. Metabolic acidosis with hemodilution due to massive absorption of normal saline as bladder irrigation fluid following holmium laser enucleation of prostate. J Anesth 30, 1060–1062 (2016). https://doi.org/10.1007/s00540-016-2256-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-016-2256-4