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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (4): 676-683. doi: 10.19723/j.issn.1671-167X.2023.04.018

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Effect of equal temperature bladder irrigation in patients with transurethral resection of prostate: A meta-analysis

Su-huan XU1,Bei-bei WANG1,Qiu-ying PANG1,Li-jun ZHONG1,Yan-ming DING2,Yan-bo HUANG1,Xin-yan CHE1,*()   

  1. 1. Department of Urology, Peking University First Hospital, Beijing 100034, China
    2. Nursing Department, Peking University First Hospital, Beijing 100034, China
  • Received:2020-07-25 Online:2023-08-18 Published:2023-08-03
  • Contact: Xin-yan CHE E-mail:che850626@126.com

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Abstract:

Objective: To evaluate the effect of equal temperature bladder irrigation on bladder spasm, postoperative bleeding, vital signs and discomfort of chills in patients of transurethral resection of prostate using meta-analysis. Methods: Several electronic databases included Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM) were searched systematically for published randomized controlled trial about equal temperature bladder irrigation in patients with transurethral resection of prostate before November 20, 2019. Two reviewers selected independently the literature in the light of the inclusion and exclusion criteria, assessed the risk of bias by quality assessment and extracted data which were consisted of clinical efficacy indexes, such as incidence of bladder spasm, severity of bladder spasm, incidence of tube plugging, amount of bladder flushing fluid, time of bladder flushing, heart rate, systolic pressure, diastolic pressure, and incidence of chills. Data were pooled using fixed-effects model or random-effects model, and the summary effect measure was calculated by risk ratio (RR) or mean difference (MD) and 95% confidence interval (95%CI). Meta-analysis was performed by Review Manager 5.3 Software. Results: In the study, 13 randomized controlled trails met the requirement with a total of 2 033 patients of transurethral resection of prostate were included, of whom 1 015 were carried out with equal temperature bladder irrigation and 1 018 with room temperature bladder irrigation. The results of meta-analysis showed that incidence of bladder spasm [RR=0.51, 95%CI (0.45, 0.57), P < 0.001], severity of bladder spasm [MD=-1.61, 95%CI (-2.00, -1.23), P < 0.001], incidence of urinary blockage [RR=0.29, 95%CI (0.19, 0.44), P < 0.001], dosage of bladder irrigation [MD=-6.75, 95%CI (-7.33, -6.17), P < 0.001], time of bladder rinse [MD=-7.60, 95%CI (-11.91, -3.29), P < 0.001], heart rate [MD=-13.68, 95%CI (-15.19, -12.17), P < 0.001], systolic pressure [MD=-29.26, 95%CI (-31.92, -26.59), P < 0.001], diastolic pressure [MD=-29.36, 95%CI (-31.75, -26.98), P < 0.001], incidence of chills and discomfort [MD=0.37, 95%CI (0.31, 0.44), P < 0.001] in equal temperature group of the patients with transurethral resection of prostate had significantly statistical difference compared with room temperature group. Conclusion: Based on current available evidence, equal temperature bladder irrigation reduced the incidence of bladder spasm and urinary blockage, relieved bladder spasm, reduced dosage and time of bladder irrigation, and hardly affected normal vital signs and increased the patient' s comfort.

Key words: Urinary bladder, Therapeutic irrigation, Temperature, Transurethral resection of prostate, Postoperative complications

CLC Number: 

  • R697.32

Figure 1

Flowchart of study selection CNKI, China National Knowledge Infrastructure; CBM, China Biology Medicine; RCT, randomized controlled trial."

Table 1

Basic characteristics of included studies"

ResearchPublishing yearSample size
(ETBIS/ RTBIS)		Bladder rinse temperature/℃Outcome
ETBISRTBIS
Ao et al[14]201439/3936-3725-29①②④⑤
Chen et al[9]2018130/13035-3721-27①②③④⑤⑥⑦⑧
Cheng et al[15]201746/4635-3721-27①③
Ding et al[16]201615/153725①⑥⑦⑧
Huang et al[17]201550/50Near 37Near 25①⑥⑦⑧⑨
Li et al[18]2010150/150< 3720.2-25.3 (mean 22.1)①②④⑤⑨
Liu et al[10]2019112/11235-3722-25①⑤
Wang[12]201445/4935-3725-29①②③④⑤
Wang[19]201748/47Near 37Near 25①③④⑤
Wen et al[20]201664/6435Indoor temperature①
Wu et al[21]201375/7535-3725①②④
Yang[22]201941/4135-3721-27①②③④⑤
Yang et al[11]2013200/200Axillary temperature (≤37)20.2-25.3①②④⑤⑨

Figure 2

The risk of bias for included studies"

Figure 3

Influence of ETBIS on incidence of bladder spasm of TURP patients ETBIS, equal temperature bladder irrigation solution; RTBIS, room temperature bladder irrigation solution; TURP, transurethral resection of prostate; CI, confidence interval."

Figure 4

Influence of ETBIS on severity of bladder spasm of TURP patients TURP, transurethral resection of prostate; ETBIS, equal temperature bladder irrigation solution; RTBIS, room temperature bladder irrigation solution; SD, standard deviation; IV, independent variable; CI, confidence interval."

Figure 5

Influence of ETBIS on incidence of tube plugging of TURP patients TURP, transurethral resection of prostate; ETBIS, equal temperature bladder irrigation solution; RTBIS, room temperature bladder irrigation solution; CI, confidence interval."

Figure 6

Influence of ETBIS on amount of bladder flushing fluid of TURP patients TURP, transurethral resection of prostate; ETBIS, equal temperature bladder irrigation solution; RTBIS, room temperature bladder irrigation solution; SD, standard deviation; IV, independent variable; CI, confidence interval."

Figure 7

Influence of ETBIS on time of bladder flushing of TURP patients TURP, transurethral resection of prostate; ETBIS, equal temperature bladder irrigation solution; RTBIS, room temperature bladder irrigation solution; SD, standard deviation; IV, independent variable; CI, confidence interval."

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