Influence of Various Irrigation Fluids on Serum Enzyme Patterns Following Transurethral Resection of the Prostate

Serum levels of a variety of enzymes were determined preoperatively and repeatedly postoperatively in a comprehensive biochemical study of 60 patients undergoing transurethral resection of the prostate (TURP). These patients were divided into four groups depending on the type of fluid used for irrigation during TURP. Prostatic acid phosphatase (PAP, analysed by radio-immunoassay) in serum showed a marked postoperative increase but wide inter-individual variation in all groups. It returned to normal within 24 to 48 hours. When water was used for irrigation, similar but less pronounced increases were observed for serum lactate dehydrogenase (LD, LD-I) and aminotransferases (ASAT, ALAT). This is interpreted as being due to an influx of irrigating fluid into the general circulation from the bladder through opened veins, by absorption from a perivesical accumulation or, in the case of PAP, also from the prostatic wound. The enzyme increases (other than PAP) may be due to their release from haemolysed red cells...