Investigating the Impact of Bladder Tumor Resection Surgery through the Urethra on Serum Osmolality and Electrolyte Levels

Abstract

Author(s): Naeimeh Naeimi Bafghi, Shirin Salagegheh, Jafar Salehi, Neda Naeimi Bafghi

Introduction: Despite being less invasive than open surgery, transurethral tumor resection has notable side effects, particularly electrolyte disorders resulting from systemic absorption of the irrigation fluid. Several studies have examined the effects of changes in irrigation fluid; however, the findings remain contradictory, and uncertainty surrounds the extent of changes in serum electrolytes and osmolality. Therefore, this study aimed to determine these changes. Materials and Methods: This observational cross-sectional study included patients aged 20 to 80 years who underwent transurethral resection of bladder tumors (TURBT) at Bahanr Hospital's treatment center in 2022. Patients with tumor diagnoses were registered for analysis. Following the selection of suitable patients, pertinent data, including demographic parameters (age and gender), were extracted and recorded from patient files. Changes in serum electrolytes and osmolality before and after the procedure were then analyzed. Results: The study investigated 31 patients, consisting of 27 men and 4 women, with an average age of 61.84 ± 10.12 years. The duration of surgery exhibited a significant positive correlation with pre-surgery osmolality (r = -0.357, p < 0.05) and post-surgery osmolality (r = -0.428, p < 0.05), as well as with potassium levels in the department (r = 0.371, p < 0.05). Significant changes in serum levels of sodium, potassium, blood sugar, serum creatinine, and osmolality (p < 0.01) were observed during the hospitalization period. Notably, BUN changes during hospitalization were also significant. Furthermore, the average osmolality decreased from 286.82 before surgery to 284.56 after surgery (p < 0.001) and increased from 284.56 after surgery to 286.66 during recovery (p < 0.05) and 287.08 during the postoperative period (p < 0.05). However, no significant differences were observed between preoperative osmolality and recovery (p = 1), preoperative osmolality and the postoperative period (p = 1), and recovery and the postoperative period (p = 1). Conclusion: The significant increase in potassium and blood sugar levels during hospitalization, despite their inversely related nature, underscores the importance of further investigations to determine the underlying causes.

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