George J. Bulkley, M.D.; Vincent J. O'Conor, M.D.; J. Kenneth Sokol, M.D.
JAMA. 1954;156(11):1042-1044. doi:10.1001/jama.1954.02950110004002.
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It is now generally accepted that irrigating fluid may be introduced directly into the vascular system during transurethral resection of the prostate and bladder neck. Several potentially serious consequences of this direct intravenous infusion have been recognized and steps taken to prevent their occurrence. The most serious complication due to the transference of irrigating fluid to the blood stream is that of intravesical and intravascular hemolysis. This results from the use of solutions not isotonic with blood. McLaughlin,1 Foley, Creevy,2 and others have pointed out the potential dangers of hemolysis, namely hemoglobinemia, hemoglobinuria, and renal damage, resulting in oliguria or anuria. These authors and others have advocated the use of isotonic irrigating solutions, such as glucose, urea, glycine, or other amino acids, during transurethral resection. The use of these solutions seems to have largely eliminated the complication of hemolysis and lower nephron nephrosis as an aftermath of transurethral


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