Transurethral Resection Of The Prostate Syndrome Research Articles

Effects of TURP Surgery on BPH Patients

Background: Benign prostatic hyperplasia (BPH) is a common condition encountered in older men and a common cause of lower urinary tract symptoms. TURP is a procedure in which the prostate is resected from an endoscopic approach which is the gold standard for bladder outlet obstruction. Even though TURP treatment still has undesirable effects, this research article explains the various effects of TURP treatment. Objective: To analyze the effects of TURP surgery. Research method: Systematic review. Research result: From 37 journals explained that Turp surgery has effects such as TURP syndrome, urethral stricture, hematuria and erectile dysfunction. Conclusion: The conclusion of this study is that TURP is a tool that is widely used to solve BPH problems, but there are several adverse effects, namely the possibility of TURP syndrome, urethral stricture, hematuria and erectile dysfunction.

Outcome of transurethral resection of the prostate (TURP) using 5% dextrose water as irrigant.

TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of irrigation fluid depends on a lot of factors. We sought to find out if the outcome of monopolar TURP using 5% dextrose water in our setting compares with findings in other studies using different fluids as irrigation fluid in monopolar TURP. This was a prospective study of 220 patients who had monopolar TURP using 5% dextrose water as irrigation fluid from 2015 to 2020. The study was completed by 220 patients. The mean age was 66.25 yrs. The mean weight of prostate was 53.2 g, and mean resected weight was 30.10 g using a mean irrigation volume of 45.35 liters, 5% dextrose water over a mean resection time of 66.08 mins. The mean changes in International Prostate Symptom Score/quality of life score (IPSS/QOLS) were statistically significant. Early complications recorded were postoperative hematuria with clot retention (1.4%), urinary tract infection (UTI) (13.2%), and secondary hemorrhage (10%). TURP syndrome was not recorded. Late complications seen within 2 years follow-up were transient urinary incontinence (6.4%), urethral stricture (4.1%), and bladder neck contracture (2.3%). There was no repeat TURP for residual adenoma within this period. TURP using 5% dextrose water has comparable outcomes to other irrigation fluids for monopolar TURP. It is a good alternative to any other irrigation fluid.

Incidence and outcome of transurethral resection of prostate syndrome at a tertiary care hospital

Introduction: Monopolar transurethral resection of prostate (M-TURP) is rarely complicated with the dreaded syndrome the TURP syndrome due to absorption of larger amount of non-electrolyte hypo-osmolar irrigation fluid (1.5% glycine), longer duration of surgery and larger amount of tissue resection. This study aims to find out the incidence and perioperative outcome of TURP syndrome after monopolar TURP. Method: This was a cross sectional study of retrospectively collected data during the period of 4 years from June 1st 2018 to 30th May 2022, in Department of Urology of Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal. Ethical approval was obtained from NAMS ethical committee. Microsoft Excel was used for descriptive analysis of the incidence of TURP syndrome, its relation with amount of resected tissue, duration of resection time, and the outcome (need of blood transfusion, length of hospital stay, mortality). Result: Out of 208 cases of monopolar TURP, 8/208(3.8%) had TURP syndrome. Patients with TURP syndrome were age group 70-85 y. Duration of surgery was >60 min was in 5/8(62.5%), resection weight >20 gm 6/8(75%), blood transfusion 1/8(12.5%), and hospital stay >3 days in all 8/8(100%) cases. Mortality was nil in patients with TURP syndrome. Conclusion: The TURP syndrome was observed in 8/208(3.8%) and it was more common in older (>60y) with longer duration (>60 min) of surgery, and larger amount of prostatic tissue (>20gm) resection.

Serial perioperative optic nerve sheath measurements for early diagnosis of the transurethral resection of prostate syndrome: an open label pilot study

BackgroundUltrasound imaging of optic sheath nerve diameter [ONSD] is reported to reflect changes consistent with intracranial pressure changes seen in traumatic brain injury and also in documented serum hyponatremia. We hypothesized that hyponatremia and hypervolemia seen during trans urethral resection of prostate [TURP] surgery may also have some association with different ONSD readings from the baseline perioperatively, resulting in early detection of TURP syndrome. In this prospective observational study, 50 adult male patients scheduled for TURP surgery meeting inclusion criteria were included and the ONSD measurements were serially recorded perioperatively. Patients with measurements ≥ 5.2 mm with either clinical symptoms or electrolyte changes suggested TURP syndrome were taken as true positive.ResultsThe sensitivity, specificity, area under the curve, positive predictive, and negative predictive value at 95%CI of ONSD for early detection of TURP syndrome was {100% [15.81 to 100.00%], 91.67% [80.02 to 97.68%], 0.96 [0.86 to 0.99%], 33.33% [4.33 to 77.72%], 100% [91.96 to 100.00%]} with a diagnostic accuracy of 95.83%. In univariate logistic regressions, the duration of surgery had a positive association with TURP syndrome [odd ratio 1.066, β coefficient 0.064, p = 0.015]. In multivariate logistic regression, we could not validate the association between these factors and TURP syndrome [p > 0.050].ConclusionsThe ONSD measurements have good diagnostic accuracy for detecting TURP syndrome, but we advocate more multi-centric studies with large sample sizes to validate this association in the multivariate regression model.

Acute tubular necrosis after transurethral resection of the prostate: a case report.

We had a 67-year-old male patient who had benign prostate hyperplasia unresponsive to tamsulosin. He underwent TURP surgery. After that, he had acute tubular necrosis because of hemolysis. We performed hemodialysis to decrease serum creatinine level. Acute tubular necrosis is the result of hemolysis. Rapid absorption of large volumes of glycerin may lead to hypotension and acute kidney injury. Using distilled water for irrigation during TURP may lead to severe complications like hypotension and acute tubular necrosis.

Unexpected systolic anterior motion of the mitral valve-related hypoxemia during transurethral resection of the prostate under spinal anesthesia: a case report

BackgroundDynamic obstruction of the left ventricular outflow tract resulting from systolic anterior motion of the mitral valve can be an unexpected cause of acute and severe perioperative hypotension in noncardiac surgery. We report a patient undergoing spinal anesthesia for transurethral resection of the prostate who experienced sudden hypoxemia caused by systolic anterior motion-induced mitral regurgitation but with a clinically picture simulating fluid overload.Case presentationAn 83-year-old man with a history of hypertension was scheduled for transurethral resection of the prostate. One hour after spinal anesthesia, he developed acute restlessness and dyspnea, with pink frothy sputum and progressive hypoxemia. Slight hypertension was noted, and an electrocardiogram showed atrial fibrillation with a rapid ventricular response. Furosemide and nitroglycerin were thus administered for suspected fluid overload or transurethral resection of the prostate syndrome; however, he then became severely hypotensive. After tracheal intubation, intraoperative transesophageal echocardiography was promptly performed, which revealed an empty hypercontractile left ventricle, significant mitral regurgitation and mosaic flow signal in the left ventricular outflow tract. Following aggressive fluid therapy, his hemodynamic changes stabilized. Repeat echocardiography in intensive care unit confirmed the presence of systolic anterior motion of the anterior mitral leaflet obstructing the left ventricular outflow tract. We speculate that pulmonary edema was induced by systolic anterior motion-associated mitral regurgitation and rapid atrial fibrillation, and the initial management had worsened his hypovolemia and provoked left ventricular outflow tract obstruction and hemodynamic instability.ConclusionsPulmonary edema caused by systolic anterior motion of the mitral valve can be difficult to clinically differentiate from that induced by fluid overload. Therefore, bedside echocardiography is paramount for timely diagnosis and prompt initiation of appropriate therapy in the perioperative care setting.

Incidence and risk factors of cognitive disorders after urologic endoscopic surgery

IntroductionPostoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.: Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.ObjectivesTo determine the incidence and risk factors of cognitive disorders after endoscopic resection in urology.MethodsThis is an observational, descriptive and analytical study carried out in the urology department of Sahloul University Hospital during a 3 month period, and enrolling patients scheduled for endoscopic resections. Collected data included socio-demographic characteristics and parameters related to the operative management. Cognitive disorders were assessed by the MOCA Test one day before the intervention, then, during the first postoperative day. Patients developing TURP syndrome were excluded.ResultsDuring the study period, 104 patients were enrolled with a mean age of 67.76 years. The sex ratio was 33.6. Main interventions were transurethral resection of bladder tumor and transurethral resection of the prostate.The incidence of cognitive disorders was 45.2% after endoscopic resection. Main Risk factors in multivariate analysis were age (p <10-3), low educational level (p <0.001), sedentary (p <0.001), smoking (p = 0.029), an age gap with spouse> 10 years (p <0.001), high blood pressure (p <0.001), myocardial infarction (p = 0.005); chronic bronchitis (p = 0.002), sleep disorders (p <0.001), preoperative concentration disturbances (p = 0.005), poor quality of patient information (p <0.05), and the type of anesthesia (p = 0.012).ConclusionsThe incidence of cognitive disorders after urologic endoscopic surgery is considerable. Patients with risk factors require preventive measures, regular screening and optimal management.DisclosureNo significant relationships.

Surgical Complications in the Management of Benign Prostatic Hyperplasia Treatment.

There are a variety of treatment options for men with symptomatic benign prostatic hyperplasia (BPH); transurethral resection of the prostate (TURP) remains the gold standard surgical treatment. The field continues to evolve with the introduction of new energy and laser technologies, increasing adoption of enucleation techniques, in addition to the advent of minimally invasive surgical technologies (MIST) that enable office-based treatments. The choice in surgical management has become very nuanced depending on a variety of patient and anatomic factors. There continues to be high success rates for surgical treatment of BPH; however, the risk profiles vary across the various surgical treatments. We sought to evaluate contemporary series and summarize the experience of complications associated with BPH treatment and management of these complications. A comprehensive literature review was performed, and identified 79 manuscripts, published between 2005 and 2021 characterizing the diagnosis and management of complications following BPH surgery. Commonly cited issues included bleeding, ureteral orifice injury, bladder neck injury, rectal injury, TURP syndrome, bladder neck contractures, urethral stricture disease, refractory OAB symptoms, and complications unique to new modalities of treatment. The practicing urologist has multiple surgical options to choose from in treating patients with symptomatic BPH. The surgical management of BPH is generally well tolerated with high objective success rates that allow for significant improvement in urinary quality of life. It is critical to understand the potential complications associated with these various treatment options, which will enable trainees and practicing urologists to better counsel patients and manage these potential complications.

Transüretral Prostat Rezeksiyonlarında İntravasküler Volüm Durumunun Dalga Değişkenlik İndeksi ile Değerlendirilmesi

Objective: Patients with benign prostatic hypertrophy (BPH) are treated with transurethral resection of the prostate (TURP). The passage of irrigation fluid into the systemic circulation can cause hypervolemia, hyponatremia and due to them TURP syndrome with restlessness, confusion, dyspnea, arrhythmia and seizures. The most important point is early diagnosis. Our aim was to reveal the statistical relationship between serum sodium (Na) values and the pleth variability index (PVI) in patients who underwent TURP. Methods: Thirty-three ASA I-III and 40-80 years old patients who underwent TURP under spinal anesthesia were included in the study. The patients were taken to the operating room and standard monitoring was applied. Venous blood samples were taken from the peripheral vascular access before and after the procedure, and Na values were determined; PVI values were recorded at 5-minute intervals from the preoperative period to the postoperative period by performing PVI monitoring. Results: The PVI data correlated with postoperative osmolarity, postoperative Na concentration, resection time and irrigation amount as an early predictor of hypervolemia and seconder hyponatremia. Conclusion: We think that more comprehensive case studies are needed in terms of the usability of PVI, which is a noninvasive method compared to blood gas sampling, an invasive method for the diagnosis of hypervolemia and hyponatremia, and that continuous monitoring and follow-up provide an advantage in early diagnosis. Keywords: Pleth variability index, benign prostatic hypertrophy, TURP, osmolarity, amount of irrigation

EDITORIAL COMMENT

For decades, transurethral resection of the prostate (TURP) was the gold standard surgical management for bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH). Spinal anesthesia was often favored in order to monitor for TURP (or TUR) syndrome, a major risk of monopolar TURP.1,2 Currently, with many surgical options available for BPH that can be performed with saline irrigation, the incidence of TUR syndrome has drastically decreased. Accordingly, use of spinal anesthesia for outlet procedures is now more dependent on practice patterns, provider preference, or reserved for patients at high risk for general anesthesia.

Comparative Evaluation of Post-TURP Complications in Patients with BPH Presenting with and Without Acute Urinary Retention

AbstractBackground Benign prostatic hyperplasia (BPH) is a prevalent urological condition affecting men at an older age. Acute urinary retention (AUR) is a severe symptom of men who develop BPH. TURP is the gold standard as the management of BPH is concerned. Our study tried to compare the post-TURP complications between patients presented with and without AUR.Materials and Methods We enrolled 126 patients, out of which 74 were in the AUR group and 52 in the non-AUR group. The mean age of patients with AUR was 62.51 years, and that for patients without AUR was 61.06 years. Statistical significance was noted in our study in patients with AUR and without AUR regarding the prostate's grading by DRE, the volume of gland, PSA level, post-TURP UTI, recatheterization post TURP, length of hospital stays with p-values 0.000, 0.000, 0.006, 0.004, 0.007, and 0.000, respectively. Statistical significance was not noted in patients with AUR and without AUR with regard to the grading of hypertension, diabetes mellitus, ischemic heart disease, post-op TURP syndrome, post-TURP hematuria, patients needing a blood transfusion, post-TURP sepsis, LUTS, post-TURP stricture, resurgery for clot retention with p values of 0.918, 1.000, 1.000, 1.000, 0.523, 0.642, 1.000, 0.319, 1.000, and 1.000, respectively.Conclusion Our study shows that post-TURP complications such as hematuria, blood transfusion rate, post-op UTI, sepsis, recatheterization, lower urinary tract stricture, resurgery, TUR syndrome, and the length of hospital stay were higher in patients who presented with AUR than in those without AUR. Post-TURP UTI complications, recatheterization rate, and the length of hospital stay were statistically significant in the AUR group compared with the non-AUR group. Therefore, it is better to intervene earlier before the patients develop AUR to minimize the complications and maximize the outcomes.

A Prospective Study on the Degree of Hyponatremia in Transurethral Resection of Prostate

Background: Systemic uptake of hypotonic fluid during irrigation performed at the time of Transurethral Resection of the Prostate (TURP) may cause electrolyte changes including sodium, potassium and calcium. The present study was aimed to assess the degree of sodium changes during Transurethral Resection of Prostate (TURP).
 Methods: 50 males aged 54 to 86 years, presented for TURP, were enrolled in the study with ASA classification of I to IV grades. Glycine 1.5% was used with height of irrigation kept at 60 cm. One day preoperatively and one hour postoperative, levels of serum sodium were measured for all the patients.
 Results: Spinal anaesthesia was given in 31 patients, whereas 19 patients were managed under general anaesthesia, with mean duration time being 72.42 ± 24.77min. The mean size of the resected prostate was 54.82 ± 25.04g. 58% patients developed mild hyponatremia, 4% had asymptomatic moderate hyponatremia and no patient developed severe hyponatremia or TURP Syndrome. The systemic diseases like hypertension, DM, or IHD found to be insignificant.
 Conclusion: TURP was associated with a high incidence of asymptomatic mild hyponatremia. Duration of operation was one of the most important factors.

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection.
 Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate.
 Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source.
 Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group.
 Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

Clinical analysis of the MyoSure hysteroscopic tissue removal system of endometrial polyps in women with an intact hymen

BackgroundTo investigate the clinical efficacy of the MyoSure hysteroscopic tissue removal system in the treatment of endometrial and cervical polyps in women with an intact hymen.MethodsRetrospective analysis was performed on the clinical data of 32 patients treated with the MyoSure hysteroscopic tissue removal system for endometrial and cervical polyps.ResultsAll the patients successfully completed the procedure. No intraoperative complications, such as cervical trauma, uterine perforation or TURP syndrome, were reported. The surgical time ranged from 5 to 35 min, with an average time of 19.3 min, and the intraoperative blood loss ranged from 2 to 50 ml with an average blood loss of 10.8 ml. After surgery, all patients were shown to have intact hymens. No residual polyp tissues were observed under the microscope, and abnormal uterine bleeding was relieved.ConclusionsThe MyoSure hysteroscopic tissue removal system can be a safe and effective treatment for endometrial and cervical polyps in women with an intact hymen.

Usefulness of bicarbonate Ringer's solution as perfusate during transurethral resection of the prostate

Transurethral resection of the prostate (TURP) is the most common standard surgical procedure used for benign prostatic hyperplasia. Transurethral resection in saline (TURis) is a bipolar electrosurgery system used to prevent TURP (or TUR) syndrome. The bicarbonate Ringer's solution is not generally used as perfusate for TURP. Hence, we compared the efficacy of the bicarbonate Ringer's solution with that of physiological saline as perfusate during TURP. This prospective, multicenter, cooperative study was conducted on 40 adult patients admitted to a medical college hospital. After obtaining informed consent from all the patients, they were divided into two groups (20 patients per group). For patients of one group, bicarbonate Ringer's solution, and for other group, physiological saline was used as perfusate. Compared to the physiological saline, the electrolyte composition of the bicarbonate Ringer's solution was closer to that of plasma. Hence, the group using bicarbonate Ringer's solution as perfusate was exhibited less variation in plasma electrolytes and blood gas data. The primary endpoints were adverse events of grade 1 or higher according to the JCOG postoperative complication criteria ver. 2.0, unintended diseases, or related signs in patients who underwent the protocol therapy. The secondary endpoints were changes in blood pH, bicarbonate ion level, anion gap (AG), base excess (BE), and chloride (C1), which occurred during and after the surgeries. Therefore, bicarbonate Ringer's solution has superior with that of physiological saline as perfusate during TURP which is directly administered into the blood vessels as an infusion solution.Bicarbonate Ringer's solution is directly administered into the blood vessels as an infusion solution.

FRESH GRADUATE UROLOGIST IN EASTERN INDONESIA: FIRST YEAR SURGERY EXPERIENCE

Objective: In present days, endourology is the hallmark of urology, including in developing countries. This study reviews the surgical experiences of a urology practitioner in the first year of his practice in the underdeveloped province in Indonesia. Material & Methods: This research is a descriptive study that retrieval patients data from the medical record during June 2018 - May 2019. Results: Total of 401 operations were obtained. There were 328 male (81.8%) and 73 female (18.2%) with the average of patients age were 52+17.77 years old. The most common diagnoses were BPH 113 cases (28.2%). bladder stone 83 cases (20.7%), and ureteral stone 52 cases (13%). The most common surgical procedures performed were TURP 120 operations (29.9%), Ureterorenoscopy (URS) 64 operations (16%), and Vesicolithotripsy 58 operations (14.5%). The upper tract procedures were 84 operations (20.9%), mainly URS 64 operations (16%). Whereas the lower procedures were 317 operations (79.1%) mainly TURP 120 operations (29.9%). The complications were bleeding post-TURP 5 cases which require blood clot evacuation (1.2%), bleeding post open nephrolithotomy 1 case which requires blood transfusion (0.2%), and TURP syndrome 1 case (0.2%) with mortality 2 patient (0.4%). All kidney stones were handled by open surgery due to lack of PCNL and ESWL set devices. Conclusion: First year urologist who are interested in serving in such areas may benefit from prioritizing the availability of upper and lower set to performed basic standard care for surgical urology without leaving the hallmark of urology.

Transurethral Resection of the Prostate (TURP): About 146 Cases at Sheikh Zayed Hospital in Nouakchott Mauritania

Introduction: Transurethral resection of the prostate (TURP), entered our service in October 2015, since then it became a part of the service daily activity. The aim of our study is to assess the acceptance of the technic by our patients and by the nursing staff and to analyze the results of our initial experience. Materials and Methods: Retrospective study over 14-month (October 2015 to December 2016); bringing together all the patients who received TURP. The inclusion criteria are to have benefited from a TURP in our service. The exclusion criteria all patients operated by other techniques. It was a monopolar resection of the prostate using a glycocolle loop, the size limit of the prostate was 65 cc or less. A questionnaire on the knowledge of the technique and its acceptance is made. The parameters studied the age of the patient; surgical indications; the course of the operation, the complications and the course. The frequency of TURP compared to other techniques and the demand for this technique by patients. The urinary catheter was left in place for 4 days, the patients were seen again on day 7 after the catheter was removed to assess the urine flow, a question regarding the opinion of the nursing staff was included and analyzed separately. Results: The total number of patients was 146; the mean age was 68.2 years. The main cause of consultation was urine retention 65%. The average duration of the intervention was 56 minutes. The average length of hospital stay was 28 hours. The urinary catheter was removed on day 4. Complications were bleeding in 7% of cases requiring blood transfusions. Failure to remove the indwelling catheter leads to revision via the transurethral route. The TURP syndrome was observed in 2 patients in our early patients but quickly resolved. The outcome was favorable in 75% of cases. Post operating management give satisfaction for nurse and acceptance was a success. Conclusion: TURP is now a routine surgical activity; it seems to have an upright place for BPH in our department; its impact on morbidity was remarkable.

Актуальные аспекты применения тулиевого лазера как перспективного метода в лечении гиперплазии предстательной железы

Lower urinary tract symptoms caused by benign prostatic hyperplasia are the most widespread and frequent urological problem among men, affecting about a third of the male population of Russia over 50 years of age. Surgical intervention is the most effective method of treating benign prostatic hyperplasia, and about 75,000 surgical interventions are performed annually in Russia. Today, of all available surgical treatments, monopolar transurethral resection of the prostate (TURP), in which enlarged prostate tissue is resected with a monopolar electrode, has been the preferred surgical method since the 1970s. This method of therapy can significantly improve the maximum urinary flow rate (Qmax), reduce obstructive symptoms assessed on the basis of the international questionnaire on the severity (IPSS) and improve the quality of life of patients. However, monopolar TURP is a rather risky procedure due to the possibility of developing serious complications such as massive bleeding or TURP syndrome (water intoxication syndrome of the body). Consequently, practicing urologists all over the world are faced with the urgent task of developing minimally invasive surgical methods of treatment, the results of which would be at least similar to those after monopolar TURP, while with fewer intra- and postoperative complications, side effects and a shorter recovery period for the patient.

A case of operative hysteroscopy intravascular absorption syndrome: Gynaecological TURP syndrome.

A case of operative hysteroscopy intravascular absorption syndrome: Gynaecological TURP syndrome.

S0545 Impact of Colonoscopy Bowel Preparation and Intra-Procedural Volume of Colonic Irrigation (VOCI) on Serum Electrolytes

INTRODUCTION: A safe and effective bowel preparation (BP) is key to the performance of high-quality colonoscopy. Colonic irrigation is often used to clear stool and improve mucosal visualization. Procedures involving high volume water irrigation in other organs (e.g. TURP syndrome) have been associated with complications due to fluid shifts and electrolyte imbalance (nausea, emesis, hypotension, altered consciousness, mortality rate 0.2-0.8%). The effect of BP and volume of colonic irrigation (VOCI) on serum electrolytes requires further investigation. METHODS: An institutionally approved quality improvement prospective cohort study was undertaken at a large VA Medical Center. Veterans scheduled for outpatient colonoscopy between 03/2019 and 03/2020 were included. Data collected included demographics, baseline electrolyte levels (within prior 6 months), BP type, volume of clear liquid diet consumed (CLD) prior to colonoscopy, procedure details including VOCI, and complications. Serum chemistry panels were obtained from the intravenous catheter placed for sedation. After 8 weeks, data for 110 patients (pilot cohort) were analyzed. To confirm findings of significant electrolyte changes, observed rates of change and missing data were used to determine a validation cohort (n = 89). A +/-10% change in serum electrolyte level AND outside the normal range was considered significant. RESULTS: There was little variation among demographics and colonoscopy characteristic between the two cohorts (Table 1). Significantly more veterans had serum electrolyte abnormalities pre-colonoscopy compared to baseline in both cohorts (56.4% vs. 32.1% in pilot cohort, P < 0.001 and 53.9% vs. 28.9% in validation cohort, P < 0.001,Figure 1), with hypokalemia being the most common (12-16%). Rates of significant electrolyte changes (> 10%) were similar between cohorts with hypokalemia and hypocalcemia being the most common. Changes in Cr, Ca, and Phos were more pronounced in the validation cohort (Table 2). CONCLUSION: Significant pre-procedure serum electrolyte changes occurred following BP, especially hypokalemia. Post-procedure hypokalemia and, the increased incidences of post-colonoscopy hypocalcemia and hypophosphatemia in the validation cohort (cohort with higher average VOCI) suggest that VOCI is associated with electrolyte shifts. Further studies are required to assess the clinical impact of these electrolyte shifts and measures to avoid them.Figure 1.: Number of Unique Patients with Abnormal Labs at Given Times.Table 1Table 2