Feasibility of serial perioperative lung ultrasound to monitor fluid shifts during thulium laser prostate enucleation.

Authors

Philipp Kuhn, Thomas Wieser, JoEllen Welter, Roman Rechner, Jan T Klein, Thomas R W Herrmann, Alexander Dullenkopf

Published in

World journal of urology. Volume 44. Issue 1. Aug 09, 2026. Epub Aug 09, 2026.

Abstract

Irrigation fluid absorption (IFA) during transurethral surgery of the prostate continues to pose a risk for fluid overload and electrolyte imbalance, yet reliable methods for quantifying absorption remain limited. Lung ultrasound (LU), increasingly used to detect pulmonary pathology, provides a noninvasive approach to assess fluid accumulation.
In this prospective single-center observational study, 36 patients aged ≥ 60 years undergoing elective urethral-sparing Thulium: YAG anatomical endoscopic enucleation of the prostate (AEEP; ThuLEP) were examined. LU was performed preoperatively and postoperatively by trained investigators, and a modified Lung Ultrasound Score (mLUS) was calculated. Perioperative data included body weight, fluid balance, biochemical parameters, and hemodynamic variables. Associations between mLUS and perioperative parameters were evaluated using Spearman correlation and linear regression analyses.
Median postoperative mLUS values increased significantly from baseline (0 (IQR 0-1) vs. 7.5 (IQR 4.5-10.5), p < 0.0001). Overall fluid balance correlated with both postoperative mLUS (ρ = 0.51, p = 0.003) and change in mLUS (ρ = 0.40, p = 0.023). The change in body weight correlated with intraoperative fluid balance (ρ = 0.66, p < 0.001), overall fluid balance (ρ = 0.58, p < 0.001), and serum chloride increase (ρ = 0.53, p = 0.007). In a simple linear regression model, overall fluid balance was associated with the change in mLUS (β = 0.00073, 95% CI 0.00015-0.00131, p = 0.015). In a multivariable linear regression model, greater overall fluid balance (p = 0.015) and chloride increase (p = 0.001) were associated with larger increases in body weight. The median weight of removed prostate tissue was 61.5 g (IQR 42-88.5), with 0.92 g per minute.
LU detected postoperative pulmonary fluid accumulation and correlated with perioperative fluid balance in elderly patients undergoing AEEP. Changes in serum chloride concentration and body weight were associated with systemic fluid uptake.

PMID:
42571674
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.