MP27-17 WATER IS SAFE AND VISUALLY SUPERIOR TO SALINE IN URETEROSCOPY: A PROSPECTIVE, RANDOMIZED, DOUBLE-BLINDED STUDY

Abstract

You have accessJournal of UrologyStone Disease: Therapy III1 Apr 2014MP27-17 WATER IS SAFE AND VISUALLY SUPERIOR TO SALINE IN URETEROSCOPY: A PROSPECTIVE, RANDOMIZED, DOUBLE-BLINDED STUDY Kathy H. Huen, Don T. Bui, Hadley W. Wyre, Li Wei, Yuan Liu, John G. Pattaras, and Kenneth Ogan Kathy H. HuenKathy H. Huen More articles by this author , Don T. BuiDon T. Bui More articles by this author , Hadley W. WyreHadley W. Wyre More articles by this author , Li WeiLi Wei More articles by this author , Yuan LiuYuan Liu More articles by this author , John G. PattarasJohn G. Pattaras More articles by this author , and Kenneth OganKenneth Ogan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.380AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Normal saline is traditionally used during ureteroscopy due to the possibility of hyponatremia, risks well documented in transurethral resection of the prostate. However, isotonic fluids may decrease visualization, making ureteroscopy challenging. Our study aims to determine whether water during ureteroscopy causes significant changes in serum sodium and osmolality, and to assess whether water provides superior visualization when compared to saline. METHODS Informed consent was obtained from adult patients who were undergoing ureteroscopy for any indication between May 2009 and July 2013 to randomly receive sterile water or 0.9% normal saline as irrigant. Patients and surgeons were blinded to fluid type. Serum chemistries were obtained before and after the procedure. Fluid clarity was measured by collecting in vivo renal fluid at end of ureteroscopy and analyzing fluid absorbance using spectrophotometry. Demographic, clinical and intraoperative variables were collected. RESULTS Ninety-nine patients (mean age 54.7 ± 14.3 years) underwent ureteroscopy, with mean ureteroscopy time of 33 ± 29 min and mean irrigation volume of 670 ± 463 mL. Among the 72 (72.7%) patients who had ureteroscopy performed for nephrolithiasis, mean number of stones was 2.7 ± 4.4 and mean stone burden was 12.4 ± 8.8 mm. There was no statistically significant difference in mean change in pre- and post-operative sodium and osmolality between patients receiving saline and those receiving water (Table 1), nor in demographic, clinical or intraoperative variables. In eight patients, renal fluid was clearer for the water group (mean absorbance 0.25 ± 0.23) compared to the saline group (0.91 ± 0.28) (p=0.043). CONCLUSIONS Water is safe as irrigant in ureteroscopies and does not cause significant changes in serum sodium and osmolality compared to saline. In addition, water may provide superior endoscopic visualization. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e280 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kathy H. Huen More articles by this author Don T. Bui More articles by this author Hadley W. Wyre More articles by this author Li Wei More articles by this author Yuan Liu More articles by this author John G. Pattaras More articles by this author Kenneth Ogan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...