In TURP, the solution used for irrigation is:

AIIMS Delhi NO-2016

Medical Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO-2016

Explanation

For traditional monopolar TURP, a non-conductive irrigation fluid is essential to allow the electrosurgical instrument to function correctly.
Glycine 1.5% is a non-conductive (electrolyte-poor) solution, which prevents the dispersal of electrical current.
It is also only slightly hypotonic, which minimizes the risk of severe hemolysis (red blood cell destruction) upon absorption compared to sterile water.
These properties make it the standard and safest choice for irrigation during monopolar TURP.

Option B: Normal Saline (NS) is an isotonic solution that contains electrolytes (sodium chloride), making it electrically conductive. Using it in monopolar TURP would cause the electrical current to disperse, preventing the instrument from cutting or coagulating tissue.
Option C: Sterile water is non-conductive, but it is highly hypotonic. If absorbed into the bloodstream in significant amounts (a known risk in TURP), it causes rapid hemolysis and severe, life-threatening hyponatremia (low sodium), leading to TURP syndrome.
Option D: Ringer's Lactate (RL) is an isotonic solution containing multiple electrolytes. Like Normal Saline, it is electrically conductive and would render a monopolar electrosurgical device ineffective.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Irrigation solutions for Transurethral Resection of the Prostate (TURP) as background academic context rather than a clinical decision trigger.
A key nursing responsibility during and after TURP is monitoring for signs of TURP syndrome, which results from excessive absorption of irrigation fluid. Symptoms include confusion, nausea, hypertension, bradycardia, and visual disturbances. Early detection is critical.
Nurses manage the continuous bladder irrigation (CBI) post-procedure using a three-way catheter. It's crucial to monitor the outflow for color (should be light pink) and clots, and to ensure the drainage volume is not significantly less than the irrigation volume, which could indicate a blockage.
Understanding the type of TURP performed (monopolar vs. bipolar) is important, as it dictates the type of irrigation fluid used and the specific risks. Bipolar TURP with saline irrigation has a much lower risk of hyponatremia and TURP syndrome.

How to Approach the Question

First, identify the core of the question: it's asking for the specific irrigation fluid used in a TURP procedure.
Recall that TURP involves electrosurgery. The type of electrosurgery (monopolar vs. bipolar) determines the required property of the irrigation fluid (non-conductive vs. conductive).
Unless specified as 'bipolar', assume the question refers to the traditional, standard monopolar TURP.
Evaluate the options based on their electrical conductivity. NS and RL are electrolyte solutions and therefore conductive, ruling them out for monopolar TURP.
Compare the remaining non-conductive options: Glycine and Sterile Water. Consider the risk of fluid absorption.
Recall that sterile water is highly hypotonic and dangerous if absorbed, causing hemolysis. Glycine is much safer as it is only slightly hypotonic. This makes Glycine the correct choice.

Concept Tested & Keywords

Concept Tested: Irrigation solutions for Transurethral Resection of the Prostate (TURP)
Stem keywords: TURP, irrigation, solution
Lead-in keywords: is
Negative lead-in flag: false

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E6 Gynecology Williams p. 43-69