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PubMed1999

Safety of distilled water as an irrigating fluid for transurethral resection of the prostate.

BACKGROUND: Irrigating fluid is necessary for transurethral resection of the prostate (TURP). Initially, distilled water was used as irrigating fluid and some advantages and complications were noted. Although other solutions were used to substitute for distilled water, we collected data for changes in electrolytes and hematocrit (Hct) during surgery to evaluate the safety of distilled water as irrigating fluid for TURP with suprapubic trocar cystostomy. METHODS: Fifty-three patients who underwent TURP using distilled water as irrigating fluid were investigated. TURP was performed with suprapubic trocar cystostomy routinely. Preoperative and postoperative blood samples were collected and analyzed for electrolytes and Hct to study any changes during surgery. RESULTS: The change in plasma sodium concentration was not statistically significant, but the decreases in blood Hct and plasma potassium concentration were statistically significant. There was no major operative complication and no clinical-evident related postoperative renal impairment. CONCLUSIONS: Distilled water is a relatively safe solution as an irrigating fluid for TURP under drainage with suprapubic trocar cystostomy, but attention must be paid to the inevitable blood loss during surgery.

Aged↗
PubMed2001

A comparison of 1.5% glycine and 2.7% sorbitol-0.5% mannitol irrigants during transurethral prostate resection.

PURPOSE: We performed a prospective randomized trial comparing glycine 1.5% with 2.7% sorbitol-0.5% mannitol irrigating solution. We evaluated blood loss, fluid absorption, temperature change, cardiac effects and postoperative symptoms. MATERIALS AND METHODS: Between April 1998 and July 1999, 205 treated patients were included in the statistical analysis. Intraoperative irrigating fluid absorption was measured with the patient on the operating table. Serum cardiac troponin I was used as a marker of perioperative myocardial damage. Operative details were recorded, including the type of anesthesia, resection time and the weight of resected tissue. Postoperative symptoms were documented prospectively. RESULTS: Mean patient age was not significantly different in the glycine and sorbitol-mannitol groups. (72.1 versus 73.7 years). American Society of Anesthesiologists grade was also comparable. Median resection time was 27 minutes and resected tissue weighed a mean of 21 gm. The median resection rate was 0.8 gm. per minute. Blood loss and temperature changes during resection were similar in the 2 groups. Overall median blood loss was 216 ml. and irrigant absorption was 140 ml. In the sorbitol-mannitol group significantly less fluid was apparently absorbed during resection (median 88.2 versus 184.4 ml.). Analysis of the incidence of symptoms of the transurethral prostate resection syndrome did not show any differences in the irrigant groups. Cardiac damage measured using troponin I also showed no significant difference in the 2 groups, although there was a high overall incidence of 7.5%. CONCLUSIONS: We noted no significant differences in 1.5% glycine and 2.7% sorbitol-0.5% mannitol as an irrigating solution for transurethral prostate resection.

Aged↗
PubMed2003

Saline nasal irrigation: Its role as an adjunct treatment.

OBJECTIVE: To review clinical evidence on the efficacy of saline nasal irrigation for treatment of sinonasal conditions and to explore its potential benefits. QUALITY OF EVIDENCE: Clinical trials, reviews, and treatment guidelines discussing nasal irrigation were obtained through a MEDLINE search from January 1980 to December 2001. Most trials were small and some were not controlled; evidence, therefore, is level II, or fair. MAIN MESSAGE: Flushing the nasal cavity with saline solution promotes mucociliary clearance by moisturizing the nasal cavity and by removing encrusted material. The procedure has been used safely for both adults and children, and has no documented serious adverse effects. Patients treated with nasal irrigation rely less on other medications and make fewer visits to physicians. Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity. CONCLUSION: Nasal irrigation is a simple, inexpensive treatment that relieves the symptoms of a variety of sinus and nasal conditions, reduces use of medical resources, and could help minimize antibiotic resistance.

Adult↗
PubMed2003

Evaluation of 18F-FDG PET with bladder irrigation in patients with uterine and ovarian tumors.

UNLABELLED: The purpose of this study was to evaluate PET using (18)F-FDG for gynecologic lesions with continuous bladder irrigation to eliminate artifacts from the (18)F-FDG activity in the bladder. METHODS: Forty-one patients were studied. They had 23 cervical uterine lesions (15 cases of cancer, 5 recurrences, 3 nonrecurrences); 8 cases of uterine corpus cancer, including 2 recurrences; and 10 ovarian masses (6 malignant, 4 nonmalignant). All cases of cancer were histologically proven; however, 2 cases of nonrecurrent uterine cervical carcinomas were diagnosed by clinical course. Continuous bladder irrigation was performed 35-55 min after intravenous administration of 185-370 MBq (18)F-FDG, and an emission scan was obtained 40-55 min after intravenous administration. Standardized uptake value (SUV) was used to estimate the degree of (18)F-FDG uptake quantitatively. RESULTS: After bladder irrigation, the (18)F-FDG activity in the urinary tract was eliminated in 33 patients, so that detection of tumor (18)F-FDG accumulation was easy. Two patients showed residual activity in the urinary bladder, and 6 patients showed activity in the ureter. An artifact was seen in 1 patient with residual activity in the urinary bladder caused by insufficient irrigation. However, these residual activities had no influence on detecting (18)F-FDG accumulation in tumor. The mean (+/-SD) of SUVs of malignant lesions was 6.04 +/- 3.22, that of nonmalignant lesions was 1.71 +/- 1.12, and the difference was significant (P = 0.0002). SUVs of all malignant lesions were greater than 2.0, and SUVs of all nonmalignant lesions, except the 1 case of ovarian fibroma, were less than 2.0. CONCLUSION: (18)F-FDG PET with continuous bladder irrigation is useful for eliminating (18)F-FDG activity in the bladder and for differentiating between malignant and nonmalignant uterine or ovarian masses.

Adult↗
PubMed2003

[Monitoring of irrigating fluid absorption in transvesical resection of the myometrium].

INTRODUCTION: Monitoring of the absorption of irrigating fluid during transcervical resection of the myometrium was studied. Irrigating fluid under pressure was used. Absorption can give symptoms as seen in transurethral resection syndrome. MATERIAL AND METHODS: A method using ethanol labelled irrigation fluid measuring ethanol in expired air was used. Serum natrium and absorbed irrigation fluid estimated by weight was measured. A total of 100 women were included. The investigation was part of the daily routine with varying anaesthetists and nurses. RESULTS: Four patients with an absorption of more than 1200 ml were identified. The end-tidal ethanol and serum natrium deficit were equally accurate in determination of this. In absorption of less than 1200 ml, the serum natrium deficit and end-tidal ethanol were not correlated to absorbed irrigation fluid judged by weighing. CONCLUSION: Determination of the end-tidal ethanol during transcervical resection is recommended as a supplement. The method is non-invasive and simple and can be repeated at any time without interruption of surgery.

Breath Tests↗
PubMed2003

[Irrigation for the post-pneumonectomy empyema infected by methicillin-resistant Staphylococcus aureus without broncho-pleural fistula; report of a successful case].

It has been known that treatments of post-pneumonectomy empyema are difficult. We report a successful case of irrigation for the post-pneumonectomy. The patient was 68-year-old man with advanced lung cancer. He underwent induction chemoradiotherapy following by pneumonectomy of the right side. A few days later after the chest drain was withdrawn, spike fever appeared. Empyema was suspected, so a 28 Fr diameter double lumen chest drain was intubated again. Turbid effusion was discharged through the drain, in which methicillin-resistant staphylococcus aureus (MRSA) was cultured. Irrigation using a lot of saline and acid electrolyzed water started. A month later, irrigator through the drain was looking clear, however, MRSA was cultured so far. After putting minomycine into the irrigator, MRSA died away. This physical and chemical irrigations were effective.

Adenocarcinoma↗
PubMed2003

[Clinical evaluation and laboratory study of ultrasonic irrigation of the root canal].

OBJECTIVE: To assess the efficacy of ultrasonic irrigation of the root canal in vivo and in vitro. METHODS: Sixty anterior teeth or premolars with the diagnosis of periapical periodontitis were divided into two groups (syringe irrigation group, group S and ultrasonic irrigation group, group U) and were evaluated clinically. Sixty extracted teeth with single straight canals were selected. Forty of them were divided into two groups and were evaluated histologically. Another twenty teeth were divided into two groups and were evaluated by SEM. RESULTS: Clinically, the number of lateral canals obturated in group U was more than that in group S (P < 0.01). The incidence of pain during irrigation were 13.3% in group S, and 3.3% in group U (P > 0.05). Histologically, the amount of organic debris of the root canals in group U were significantly less than that in group S (P < 0.01). By SEM study, the number of visible open dentinal tubules in group U were significantly greater than that in group S (P < 0.05). CONCLUSION: Ultrasonic irrigation of the root canal will be a useful technique in root canal therapy.

Humans↗
PubMed2003

[Management of mediastinitis after pediatric cardiac surgery with continuous closed irrigation method].

Two cases are presented as a successful management for mediastinitis with the continuous closed irrigation method after pediatric cardiac surgery. The continuous closed irrigation method has significant advantages over conventional open irrigation method or muscle flap in pediatric cases, because the system is simple to handle and easy to wash out any infectious tissue debris without additional invasive intervention. However, adequate duration of the irrigation and subsequent antibiotic regimen is still unclear. We conclude that the continuous closed irrigation method is an effective management which is applicable to most of mediastinitis cases after pediatric cardiac surgery.

Blood Vessel Prosthesis Implantation↗
PubMed2003

[Irrigants and intracanal medicaments in endodontics].

Modern, biologic root canal therapy should be performed with suitable irrigating solutions and intracanal medicaments. The goal of endodontic treatment is to free the treated tooth from infection and prevent reinfection as thoroughly as possible by means which do not put the organism at risk. In this review of the literature, an evidence-based concept for irrigation and medication of root canal systems is presented. Irrigants and medicaments are discussed with respect to their antimicrobial, tissue-dissolving and endotoxin-decontaminating capacity in relation to their systemic toxicity. Recent findings pertaining to interactions of root canal medicaments and irrigating solutions and their impact on a sound irrigating and medicating concept are discussed.

Anti-Infective Agents, Local↗
PubMed2004

Plaque removing capacity of a novel high pressure water irrigator.

PURPOSE: To evaluate the capacity of a novel oral water irrigator to remove established plaque deposits. METHODS: The study was designed as a randomized two-treatment, crossover, examiner-blinded clinical trial. The plaque removing capability of a prototype oral irrigator was compared to a conventional electric toothbrush. After 48 hours of plaque accumulation the 35 subjects were randomly assigned to professional plaque removal by either oral irrigation or by electric toothbrushing for a timed 2-minute total cleaning. Pre- and post cleaning plaque was disclosed and gingival abrasions were identified. Plaque was assessed on gingival and approximal surfaces of the oral and buccal sites according to the Rustogi et al modification of the Modified Navy Plaque Index. The assessment of gingival abrasions was performed according to the method introduced by Danser et al. RESULTS: The overall plaque removing capacity of the oral irrigator reached approximately 40.7 +/- 16.7% as compared to 71.6 +/- 11.5% by the electric toothbrush. Similar effects were observed for the gingival and approximal areas. The electric toothbrush caused significantly more gingival abrasions than the oral irrigator.

Adult↗
PubMed2004

[Three cases of organophosphate poisoning treated with pralidoxime iodide and whole-bowel irrigation].

We encountered three cases of organophosphate poisoning treated with pralidoxime iodide (PAM) and whole-bowel irrigation without atropine sulfate. All patients recovered without persistence or recurrence of toxic symptoms and without any somatic after effects. In case 1, a 48-year-old woman ingested approximately 5 g of ethylthiometon in a suicide attempt. She was transferred to the hospital because of cardiopulmonary arrest. After resuscitation, she was transferred to our center. She was placed on a ventilator and received i.v. PAM and polyethylene glycol-electrolyte through a nasojejunal tube for whole-bowel irrigation. Six days later, serum ChE was improved. In case 2, a 51-year-old man ingested approximately 30 g of malathion in a suicide attempt and was transferred to our center because of dyspnea. He was treated with PAM and whole-bowel irrigation, but did not require a respirator. Serum ChE already showed improvement the following day. In case 3, a 31-year-old man ingested approximately 50 g of DEP in a suicide attempt and was transferred to our center because of unconsciousness. He was treated with a respirator, PAM and whole-bowel irrigation. Serum ChE improved within two days. These cases suggest the possibility that preferential whole-bowel irrigation without atropine sulfate prevents the persistence or recurrence of the toxic effects of organophosphate.

Adult↗
PubMed1992

Natural evacuation versus irrigation.

The comparison of the influences of the natural evacuation method and the colostomy irrigation method on complaints, daily activities and psychosocial conditions revealed that colostomy irrigation, as compared to natural evacuation, imposes less distress on the patient, causes fewer skin problems and is less of a financial burden. In daily activities, irrigation causes fewer difficulties in comparison to natural evacuation in the areas of bathing and sleeping. Furthermore, the frequency of going outdoors remains at the same level as in pre-operative days and the patients are able to adjust to daily activities post-operatively. By comparing irrigation patients and natural evacuation patients from a psychosocial standpoint, irrigation patients hold a higher degree of self-esteem, have fewer anxieties and fewer worries than those using natural evacuation. The instruction of evacuation control, management of gas odor, and a great deal of psychosocial support needs to be given to natural evacuation patients.

Activities of Daily Living↗
PubMed2005

[Subgingival irrigation combined with scaling and root planing. Results of a study with chlorhexidine and sodium hypochlorite].

Scaling and root planning is more and more associated with subgingival irrigation in chronics periodontal treatment. It is unreasonable to expect to control periodontal infections by mechanical treatment alone. Most patients do not achieve the necessary level of manual dexterity or motivation to control their plaque at home. It is rather better to deliver antimicrobial agents directly into the periodontal pocket. The aim of this study is to evaluate the action of subgingival irrigation associated to periodontal scaling on the clinical parameters and to compare the effects of chlorhexidine (Eludril) and sodium hypochlorite (Dakin Cooper) on adult's chronics periodontitis treatment. At the level of Plaque Index, Gingival Index and Bleeding on Probing, the results show that Eludril irrigation associated to scaling is lightly efficacious than Dakin cooper irrigation associated to scaling. And, the last one also is lightly efficacious than scaling alone. However, at the level of pocket depth, scaling alone has been also effective than scaling associated with subgingival irrigation.

Adult↗
PubMed2005

The use of vesical irrigation system dual pump Endo FMS urology in the endoscopic therapy of benign prostatic hyperplasia.

OBJECTIVE: Transurethral resection of the prostate (TURP) remains the reference standard treatment in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). The objective of this study was to determine whether vesical irrigation during TURP with the dual pump system Endo FMS Urology is more efficient than standard gravity irrigation. METHODS: A group of 30 patients who underwent TURP using the Endo FMS Urology was compared to a group of 30 patients treated with standard vesical irrigation. RESULTS: A 40% decrease of fluid irrigated, a 10% decrease of time for procedure and a 10% increase in the volume of the resected tissue was observed in patients treated with the Endo FMS Urology compared to controls treated with standard vesical irrigation.

Case-Control Studies↗
PubMed2005

The use of vesical irrigation system dual pump Endo FMS urology in the endoscopic therapy of the vesical neoplasms.

OBJECTIVE: The objective of this study was to determine whether vesical irrigation during transurethral resection of bladder tumours (TURBT) with the dual pump system for the intracavitary irrigation Endo FMS Urology is more efficient than the standard gravity technique. METHODS: One hundred patients suffering from vesical neoplasms underwent TURBT using the Endo FMS Urology (group A). They were compared to 100 patients previously (2002-2003) treated endoscopically for vesical tumours with the standard endovesical irrigation method (group B). RESULTS: We demonstrated a reduction of the average time of resection of 10% in favour of patients of group A, a reduction of 39% of the amount of fluid of vesical irrigated in favour of patients of group A. No differences were observed in the recurrence rate of tumours at 3 months and in need of endoscopic revision in the 48 hours following TURBT. Two patients required blood transfusion after TURBT in group B, none in group A. The average time of hospitalisation in group A was less than one day. CONCLUSIONS: On the basis of this experience the use of Endo FMS Urology Irrigation System in TURBT is strongly recommended.

Adult↗
PubMed2005

[Sialographic, sialoendoscopic and irrigation fluid study in chronic obstructive parotitis].

OBJECTIVE: To study the sialographic changes and to compare the changes with sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis (COP). METHODS: This study involved 27 patients with a long history of parotid swelling. All patients were examined by X-ray, sialography, and were diagnosed as COP without sialolithiasis. Sialoendoscopy was used to observe the ductal system and irrigation treatment performed. The irrigated liquid was centrifuged and the deposits of fluid were stained and observed under microscopy. The sialographic changes were classified as previous studies and compared with sialoendoscopic and irrigation fluid findings. RESULTS: The sialographic changes of COP in 27 patients included 9 cases with type I, 5 cases with type II, 9 cases with type III and 3 cases with type IV changes, 1 case was normal. Marked obstructive factors such as stricture of ductal system were revealed in 21 cases on the sialogram. Sialoendoscopic examination showed that the ductal system was filled with fiber-like substances and hyperaemia of ductal wall in all cases. While few and thin fiber-like substances were found in the COP with sialographic type I and type II changes, many thick wadding or mass fiber-like substances were revealed in COP with sialographic type III and IV changes. Microstones were found in 2 COP with sialographic type III changes which were stained and identified by microscopy. Foreign body (drug bar) was found in one COP with sialographic type I changes with sialoendoscopy. Irrigation fluid examination showed fiber-like substance was composed of desquamative duct epithelial cells, neutrophil, lymphocytes, acidophile. Some epithelial cells were found in two microliths. CONCLUSIONS: The pathological basis of fiber-like substance on sialoendoscopy is desquamative duct epithelial cells. Fiber-like substance in the lumen of ductal system is considered as one of the obstructive factors in COP. Sialoendoscopic findings is related to sialographic changes.

Adult↗
PubMed2006

Non-invasive treatment of intractable posterior epistaxis with hot-water irrigation.

Posterior nose bleeding is a frequent and challenging emergency. The authors report their experience using hot water irrigation as a non-invasive treatment option for posterior epistaxis. Between January 2003 and January 2005 a group of 103 patients were enrolled in this prospective study evaluating the effectiveness of a "hot water irrigation" technique to control acute posterior nose bleeding. All patients with posterior epistaxis were included, whereas anterior epistaxis was controlled using conventional methods. The patient's nose was initially anaesthetized with topical Tetracain 4% (without vasoconstriction) and a modified epistaxis-balloon-catheter was introduced into the bleeding nasal cavity obstructing the choana. The bleeding nasal cavity was continuously irrigated using 500 ml of 50 degrees C hot water. In a total of 84 patients (82%) the bleeding was successfully and permanently stopped. Forty-seven of these patients (56%) regularly took antiplatelet agents or anticoagulants. The method failed in 19 of 103 patients (18%). In the group with unsuccessful irrigation, 11 patients (58%) were receiving treatment with antiplatelet agents or anticoagulants. Their proportion was not different from the successfully treated group. The success rate of hot water irrigation as non-invasive treatment of posterior epistaxis appears at least as effective as conventional methods. However it avoids painful packing, hospitalizations, or immediate surgery, and allows the patient to breath normally through his open nasal cavities.

Adolescent↗
PubMed2006

Clinical and microbiological effects of subgingival irrigation with Streblus asper leaf extract in chronic periodontitis.

OBJECTIVE: To determine the clinical and microbiological effects of subgingival irrigation of Streblus asper leaf extract (SAE) solution as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients. METHODOLOGY: Forty-two subjects were included and treated with SRP at baseline (week 0), followed by subgingival irrigation with saline (control group, n=21) or SAE (test group, n=21) solution (80 mg/ml) at weeks zero, one, two, three, and four. Clinical parameters, including gingival index (GI), plaque index (PI), probing depth (PD), and relative attachment level (RAL) were measured at weeks zero, six, and 12. Microbiological parameters were measured at weeks zero, one, two, three, four, six, and 12. RESULTS: The SAE solution significantly reduced the GI compared with saline solution (p < 0.01). However, a reduction in PI, PD, and RAL was noted for both groups, with no statistically significant intergroup differences. The reduction in the number ofA. actinomycetemcomitans and/or P. gingivalis was maintained throughout the study period after subgingival irrigation with SAE solution, while an initial reduction and subsequent rebound were observed after saline irrigation. However, the mean number and mean percentages of sites with 10 times the reduction in number of these bacteria were not significantly different between the two groups. CONCLUSION: Subgingival irrigation with SAE solution as an adjunct to SRP is effective at reducing gingival inflammation, but not PD, RAL, and the number of A. actinomycetemcomitans and/or P. gingivalis.

Actinomyces↗