Sterile Water Versus Isotonic Saline Solution as Irrigation Fluid in Percutaneous Nephrolithotomy Abstract PDF

We evaluated the safety of sterile water as an irrigationsolution for percutaneous nephrolithotomy (PCNL).

Forty-four patients with kidney calculi wereenrolled in this study and randomly divided into two groups for PCNL.Approaches to the calculi were through a single subcostal access with anAmplatz sheath, and either sterile water or isotonic saline solution was usedas the irrigation fluid. Serum hemoglobin, haptoglobin, sodium, potassium,and creatinine were measured before and 12 hours after the procedure. Thepatients were evaluated for signs of transurethral resection of the prostatesyndrome during the operation for 24 hours afterwards.

The mean calculus size, irrigation volume, irrigation time, and agewere not significantly different between the two groups. Hemolysis occurredin 10 and 9 patients in sterile water and saline groups, respectively. The meanchange in haptoglobin level was -1.7 ± 59 mg/dL in the sterile water and 11 ±55 mg/dL in the saline group. Also, the mean change in plasma sodium levelwas -2.2 ± 4.7 and -0.4 ± 3.8 in sterile water and saline groups, respectively.None of these values were significantly different between the two groups, norwere other laboratory values. None of the patients developed transurethralresection of the prostate syndrome or needed transfusion.

Sterile water is an inexpensive alternative to isotonic saline forirrigation during PCNL. We did not find any difference between the twoirrigation solutions regarding the safety; however, this should be confirmedfurther, especially for larger calculi.