LinkedIn

 آمار

تعداد نشریات20
تعداد شماره‌ها1,214
تعداد مقالات11,083
تعداد مشاهده مقاله75,882,413
تعداد دریافت فایل اصل مقاله100,548,182
Gholipour, Farshad, Bahrami Samani, Hossein, Assadi, Alireza, Behnamfar, Amir, Nazarpour, Mohammadjavad, Saberi, Narjes. (1404). Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A Randomized Clinical Trial. سامانه مدیریت نشریات علمی, (), -. doi: 10.30476/ijms.2025.105024.3860
Farshad Gholipour; Hossein Bahrami Samani; Alireza Assadi; Amir Behnamfar; Mohammadjavad Nazarpour; Narjes Saberi. "Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A Randomized Clinical Trial". سامانه مدیریت نشریات علمی, , , 1404, -. doi: 10.30476/ijms.2025.105024.3860
Gholipour, Farshad, Bahrami Samani, Hossein, Assadi, Alireza, Behnamfar, Amir, Nazarpour, Mohammadjavad, Saberi, Narjes. (1404). 'Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A Randomized Clinical Trial', سامانه مدیریت نشریات علمی, (), pp. -. doi: 10.30476/ijms.2025.105024.3860
Gholipour, Farshad, Bahrami Samani, Hossein, Assadi, Alireza, Behnamfar, Amir, Nazarpour, Mohammadjavad, Saberi, Narjes. Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A Randomized Clinical Trial. سامانه مدیریت نشریات علمی, 1404; (): -. doi: 10.30476/ijms.2025.105024.3860

Prophylactic Intravenous Furosemide for Reducing Hyponatremia Risk in Monopolar Transurethral Prostate Surgery: A Randomized Clinical Trial

Iranian Journal of Medical Sciences
مقالات آماده انتشار، اصلاح شده برای چاپ، انتشار آنلاین از تاریخ 23 شهریور 1404    اصل مقاله (456.74 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2025.105024.3860
نویسندگان
Farshad Gholipour1؛ Hossein Bahrami Samani* 1؛ Alireza Assadi2؛ Amir Behnamfar1؛ Mohammadjavad Nazarpour1؛ Narjes Saberi1
1Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده
Background: Transurethral resection of the prostate (TURP) is the gold standard surgical treatment for benign prostatic hyperplasia (BPH). Despite its widespread use, monopolar TURP carries a risk of significant complications, particularly transurethral resection (TUR) syndrome leading to hyponatremia and fluid overload. The study evaluates whether prophylactic furosemide prevents hyponatremia and TUR syndrome in monopolar TURP.
Methods: This study was a triple-blind randomized clinical trial conducted in Al-Zahra and Khorshid educational hospitals of Isfahan, Iran, in 2022-2023. Patients undergoing monopolar TURP, were divided into two groups: those receiving preoperative furosemide and a control group. The primary outcomes were changes in serum sodium levels and the incidence of hyponatremia. Secondary outcomes included fluid balance, complication rates, and recovery times. Continuous data were analyzed using t test/Mann-Whitney U, categorical data with Fisher’s exact test, and time-based changes with repeated measures ANOVA. Normality was checked via Kolmogorov-Smirnov, and power analysis determined sample size.
Results: The furosemide group demonstrated a significantly lower incidence of hyponatremia than the control group (P=0.008). Additionally, serum sodium levels were significantly higher in the furosemide group after surgery (P=0.011), while potassium levels were lower (P=0.003). Mild hypokalemia was observed as a manageable side effect, primarily in patients with baseline potassium levels below 4.1 mmol/L.
Conclusion: Preoperative administration of furosemide effectively reduces the risk of TUR syndrome during monopolar TURP. Furosemide effectively reduces hyponatremia but may increase hypokalemia in some cases, limiting its clinical utility during monopolar TURP. Patient-specific assessment and further research are needed to ensure its safe and effective use.
Trial registration number: IRCT20211208053328N2.

تازه های تحقیق

Farshad Gholipour (Google Scholar)

Hossein Bahrami Samani (Google Scholar)

کلیدواژه‌ها
Transurethral resection of prostate؛ Hyponatremia؛ Furosemide؛ Water-electrolyte imbalance؛ Postoperative complications
مراجع
  1. Yue L, Wang T, Ge Y, Ge M, Zhang C, Hou Q, et al. Prevalence and heritability of benign prostatic hyperplasia and LUTS in men aged 40 years or older in Zhengzhou rural areas. Prostate. 2019;79:312-9. doi: 10.1002/pros.23737. PubMed PMID: 30450670.
  2. Collaborators GBDBPH. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2022;3:e754-e76. doi: 10.1016/S2666-7568(22)00213-6. PubMed PMID: 36273485; PubMed Central PMCID: PMCPMC9640930.
  3. Miernik A, Gratzke C. Current Treatment for Benign Prostatic Hyperplasia. Dtsch Arztebl Int. 2020;117:843-54. doi: 10.3238/arztebl.2020.0843. PubMed PMID: 33593479; PubMed Central PMCID: PMCPMC8021971.
  4. Demirel I, Ozer AB, Bayar MK, Erhan OL. TURP syndrome and severe hyponatremia under general anaesthesia. BMJ Case Rep. 2012;2012. doi: 10.1136/bcr-2012-006899. PubMed PMID: 23166168; PubMed Central PMCID: PMCPMC4543890.
  5. Hao J, Li Y, Zhang X, Pang C, Wang Y, Nigwekar SU, et al. The prevalence and mortality of hyponatremia is seriously underestimated in Chinese general medical patients: an observational retrospective study. BMC Nephrol. 2017;18:328. doi: 10.1186/s12882-017-0744-x. PubMed PMID: 29089024; PubMed Central PMCID: PMCPMC5664828.
  6. Adrogue HJ, Tucker BM, Madias NE. Diagnosis and Management of Hyponatremia: A Review. JAMA. 2022;328:280-91. doi: 10.1001/jama.2022.11176. PubMed PMID: 35852524.
  7. McGowan-Smyth S, Vasdev N, Gowrie-Mohan S. Spinal Anesthesia Facilitates the Early Recognition of TUR Syndrome. Curr Urol. 2016;9:57-61. doi: 10.1159/000442854. PubMed PMID: 27390576; PubMed Central PMCID: PMCPMC4911525.
  8. Mao X, Zhou Z, Cui Y, Zhang Y, Yang M. Outcomes and Complications of Bipolar vs. Monopolar Energy for Transurethral Resection of Bladder Tumors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Surg. 2021;8:583806. doi: 10.3389/fsurg.2021.583806. PubMed PMID: 34150834; PubMed Central PMCID: PMCPMC8206278.
  9. Pradhan MM, Poudyal S, Chapagain S, Luitel B, Chalise P, Sharma U, et al. Safety and efficacy of bipolar vs monopolar transurethral resection of bladder tumor-A randomized controlled trial. Nepal Medical College Journal. 2020;22:123-8. doi: 10.3126/nmcj.v22i3.32630.
  10. Hawary A, Mukhtar K, Sinclair A, Pearce I. Transurethral resection of the prostate syndrome: almost gone but not forgotten. J Endourol. 2009;23:2013-20. doi: 10.1089/end.2009.0129. PubMed PMID: 19821694.
  11. Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and postoperative complications. a cooperative study of 13 participating institutions evaluating 3,885 patients. 1989. J Urol. 2002;167:999-1003. PubMed PMID: 11908420.
  12. Huang X, Dorhout Mees E, Vos P, Hamza S, Braam B. Everything we always wanted to know about furosemide but were afraid to ask. Am J Physiol Renal Physiol. 2016;310:F958-71. doi: 10.1152/ajprenal.00476.2015. PubMed PMID: 26911852.
  13. Sorodoc V, Asaftei A, Puha G, Ceasovschih A, Lionte C, Sirbu O, et al. Management of Hyponatremia in Heart Failure: Practical Considerations. J Pers Med. 2023;13. doi: 10.3390/jpm13010140. PubMed PMID: 36675801; PubMed Central PMCID: PMCPMC9865833.
  14. Lapsia V, Kazory A. Loop diuretics for heart failure-associated hyponatremia. Am J Med. 2010;123:e5-6. doi: 10.1016/j.amjmed.2009.12.035. PubMed PMID: 20670712.
  15. Harada K, Ukai Y, Kanakubo K, Yamano S, Lee J, Kurosawa TA, et al. Comparison of the diuretic effect of furosemide by different methods of administration in healthy dogs. J Vet Emerg Crit Care (San Antonio). 2015;25:364-71. doi: 10.1111/vec.12301. PubMed PMID: 25885944.
  16. Gandhi A, Husain M, Salhiyyah K, Raja SG. Does perioperative furosemide usage reduce the need for renal replacement therapy in cardiac surgery patients? Interact Cardiovasc Thorac Surg. 2012;15:750-5. doi: 10.1093/icvts/ivs208. PubMed PMID: 22761122; PubMed Central PMCID: PMCPMC3445350.
  17. Oh H, Kim S, Kim S, Lee J, Yun S, Yoon J, et al. Evaluation of the ureteral jet in dogs by using color Doppler ultrasonography. J Vet Sci. 2017;18:399-406. doi: 10.4142/jvs.2017.18.3.399. PubMed PMID: 28057900; PubMed Central PMCID: PMCPMC5639093.
  18. van den Tillaart SA, Busard MP, Trimbos JB. The use of distilled water in the achievement of local hemostasis during surgery. Gynecol Surg. 2009;6:255-9. doi: 10.1007/s10397-008-0464-0. PubMed PMID: 20234842; PubMed Central PMCID: PMCPMC2837248.
  19. Huguet EL, Keeling NJ. Distilled water peritoneal lavage after colorectal cancer surgery. Dis Colon Rectum. 2004;47:2114-9. doi: 10.1007/s10350-004-0788-4. PubMed PMID: 15657663.
  20. Saif A, Teke M, Ryan C, Papai E, Nevler A, Hernandez JM, et al. The WASH (Water or Saline at High Volumes) Trial: A Randomized Trial to Assess the Survival Impact of Extensive Peritoneal Lavage Using Distilled Water or Saline at High Volumes After Pancreatic Resection for Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol. 2022;29:5372-4. doi: 10.1245/s10434-022-11978-3. PubMed PMID: 35661956.
  21. Paulus E, Santoso J, Sims M, Patel J, Pfeffer L. Cytotoxicity of Hypo-osmolar Lavage Fluid on Ovarian Cancer Cells. J Med Surg Pathol. 2016;1:2. doi: 10.4172/2472-4971.1000105.
  22. Hoorn EJ, Zietse R. Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines. J Am Soc Nephrol. 2017;28:1340-9. doi: 10.1681/ASN.2016101139. PubMed PMID: 28174217; PubMed Central PMCID: PMCPMC5407738.
  23. Seif NE, Shehab HA, Elbadawy AM. Prophylaxis versus Treatment against Transurethral Resection of Prostate Syndrome: The Role of Hypertonic Saline. Anesth Essays Res. 2020;14:104-11. doi: 10.4103/aer.AER_148_19. PubMed PMID: 32843802; PubMed Central PMCID: PMCPMC7428123.
  24. Sterns RH, Riggs JE, Schochet SS, Jr. Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314:1535-42. doi: 10.1056/NEJM198606123142402. PubMed PMID: 3713747.
  25. Singh DK, Baj B, Goyal V, Jethava D. The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery-A randomized double blind study. Indian Journal of Clinical Anaesthesia. 2021;8:321-5. doi: 10.18231/j.ijca.2021.059.
  26. Tong Xuan H, Dinh Thi Thu T, Ngo Van D, Nguyen Minh L. Successful Treatment of Pulmonary Edema Caused by Transurethral Resection of the Prostate Syndrome. Res Rep Urol. 2021;13:297-301. doi: 10.2147/RRU.S288614. PubMed PMID: 34104635; PubMed Central PMCID: PMCPMC8179823.
  27. Buckley LF, Carter DM, Matta L, Cheng JW, Stevens C, Belenkiy RM, et al. Intravenous Diuretic Therapy for the Management of Heart Failure and Volume Overload in a Multidisciplinary Outpatient Unit. JACC Heart Fail. 2016;4:1-8. doi: 10.1016/j.jchf.2015.06.017. PubMed PMID: 26656139.
  28. Ahmed S, Guffey D, Minard C, Workeneh B. Efficacy of loop diuretics in the management of undocumented patients with end-stage renal disease. Am J Emerg Med. 2016;34:1552-5. doi: 10.1016/j.ajem.2016.05.042. PubMed PMID: 27260551.
  29. Rondon-Berrios H, Sterns RH. Hypertonic Saline for Hyponatremia: Meeting Goals and Avoiding Harm. Am J Kidney Dis. 2022;79:890-6. doi: 10.1053/j.ajkd.2021.07.020. PubMed PMID: 34508830; PubMed Central PMCID: PMCPMC10332848.
  30. Burst V, Grundmann F, Kubacki T, Greenberg A, Becker I, Rudolf D, et al. Thiazide-Associated Hyponatremia, Report of the Hyponatremia Registry: An Observational Multicenter International Study. Am J Nephrol. 2017;45:420-30. doi: 10.1159/000471493. PubMed PMID: 28419981; PubMed Central PMCID: PMCPMC5452281.
  31. Assadi F. Hyponatremia: a problem-solving approach to clinical cases. J Nephrol. 2012;25:473-80. doi: 10.5301/jn.5000060. PubMed PMID: 22307436.
آمار
تعداد مشاهده مقاله: 10
تعداد دریافت فایل اصل مقاله: 3


سامانه مدیریت نشریات علمی. قدرت گرفته از سیناوب