Why is saline solution not preferred for TUR procedures?

The primary reason saline solution is not preferred for transurethral resection (TUR) procedures relates to the risk of hemolysis. In TUR procedures, the use of saline can lead to the introduction of fluid into the bloodstream through microtears in the tissue, especially when there is a current of electricity used in resections. Saline, particularly when used in large volumes, can also create an imbalance in electrolytes, which may lead to complications such as dilutional hyponatremia. Additionally, saline solutions can potentially cause hemolysis of red blood cells, which can further contribute to these electrolyte disturbances and other complications.

In the context of TUR procedures, it is critical to keep in mind the characteristics of the irrigation solution used. Solutions that do not pose a risk of hemolysis, like glycine, sorbitol, or mannitol, are often preferred because they do not adversely affect the red blood cells or lead to significant shifts in serum electrolytes.

Understanding the implications of solution choice during TUR can significantly impact patient safety and outcomes, making it paramount for surgical assistants to grasp the risks associated with different irrigation fluids.