Effect of glycine on retroperitoneal and intraperitoneal organs in the rat model

Maatman, Thomas J.; Musselman, Paul W.; Kwak, Yun Sik; Resnick, Martin I.

doi:10.1002/pros.2990190406

Cited by 14 publications

(9 citation statements)

References 6 publications

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“…We could not confirm that proteinaceous material is deposited in the proximal tubules after glycine infusion, as has been reported by Maatman et al [14], However, some glycine infusions were followed by a focal necrosis with an inflammatory reaction in the myocardium. Inter estingly, the strongest reaction was observed after 24 h. These lesions were observed in the subendocardial areas of the left ventricle and in the papillary muscles, which are the most common sites for general hypoxic (not ischemic or toxic) cardiovascular injury [15], The overhydration of the myocardium might have compromised the blood sup ply of the mentioned areas and caused these hypoxic lesions which had functional consequences demonstrated by ECG changes as well as fatal outcome in some instances.…”

contrasting

confidence: 50%

Morphological and X-Ray Microanalytical Changes in Mammalian Tissue after Overhydration with Irrigating Fluids

Hahn

Nennesmo²,

Rajs³

et al. 1996

Eur Urol

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contrasting

confidence: 50%

Morphological and X-Ray Microanalytical Changes in Mammalian Tissue after Overhydration with Irrigating Fluids

Hahn

Nennesmo²,

Rajs³

et al. 1996

Eur Urol

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“…Glycine toxicity usually presents with neurological or cardiovascular symptoms [10]. However, consistently with the present hypothesis, Maatman et al, in an attempt to generate a rat model of TUR syndrome by administration of different amounts of glycine 1.5%, both intravenously and retroperitoneally, observed dose-dependent toxic effects of glycine on both liver and kidney [11]. Furthermore, Hahn et al observed hydrops and swelling of the hepatocytes following intravenous infusion of 100 ml/kg of glycine 1.5% and ethanol 1.0% in rabbits [12].…”

Section: Discussionsupporting

confidence: 66%

Transient acute liver failure complicating transurethral resection syndrome

Tuccori

Guidi²,

Montagnani

et al. 2010

Scandinavian Journal of Urology and Nephrology

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Transurethral resection (TUR) syndrome, resulting from dilutional hyponatraemia for excessive absorption of irrigating fluid, represents the most relevant complication of transurethral resection of prostate (TURP). Ethanol is used as a tracer in the irrigant solution to monitor fluid absorption with a breathalyser. An unusual case of transient acute liver failure complicating TUR syndrome is reported. A 54-year-old male patient, without risk factors for the development of toxic hepatitis, was subjected to TURP for treatment of benign prostatic hyperplasia. Fluid absorption (2275 ml), estimated by breathalyser, exceeded maximum allowed absorption (2000 ml) only at the end of the surgical intervention. No signs of possible toxicity were evident in the few hours following the intervention. About 10 h after the end of TURP, the patient developed sweating, vomiting and diarrhoea. Laboratory analysis revealed severe hyponatraemia (116 meq/l) with signs of severe liver impairment (total bilirubin 5.8 mg/dl, alanine aminotransferase 56,500 U/l, aspartate aminotransferase 32,700 U/l), kidney failure (serum creatinine 1.93 mg/dl) and serum ethanol levels of 219 mg/dl (0.2%). The patient was treated with acetylcysteine 150 mg/kg i.v. and furosemide 50 mg i.v. Liver and renal functions improved in few days and recovered completely within 30 days. The TUR syndrome observed in this case was probably extravascular in nature, and could have been identified and prevented by measuring ethanol levels 10 min after ending the surgical procedure. The performance of such a test should be strongly recommended to all surgeons. The clinicians attributed the development of liver impairment in this case to ethanol toxicity. However, further studies are warranted to confirm whether hepatic injury can represent a possible complication of TUR syndrome when ethanol solution is used as irrigant fluid.

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“…Glycine 1.5%, but not Ringer's acetate or water, given retroperitoneally to rats caused degenerative changes in the liver and toxic cellular changes in the kidneys [13]. …”

Section: Pathologymentioning

confidence: 99%

Glycine 1.5% for Irrigation Should Be Abandoned

Hahn

2013

Urol Int

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Background: Glycine 1.5% has long maintained a dominating role as an irrigating solution for monopolar transurethral resection of the prostate (TURP), as well as for certain other transurethral procedures. Materials and Methods: This review summarizes the findings ofsystematic experimental and clinical studiesin which glycine 1.5% for irrigation was infused/absorbed and the outcome compared to at least one other irrigating fluid, including the isotonic saline used for bipolar TURP. Results: There were 11 studies in animals, 3 in volunteers and 6 in patients undergoing TURP. With only one exception, which is probably due to low power, these studies either show a poorer outcome after administration or absorption of glycine solution or else that glycine 2.2% is more toxic than glycine 1.5%. The poorer outcomes consisted of more tissue damage or higher mortality (animals) or more symptoms (volunteers and patients). Conclusion: The safety of monopolar TURP would be improved by replacing glycine 1.5% with some other electrolyte-free fluid. The author argues that glycine 1.5% should be abandoned completely.

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Effect of glycine on retroperitoneal and intraperitoneal organs in the rat model

Cited by 14 publications

References 6 publications

Morphological and X-Ray Microanalytical Changes in Mammalian Tissue after Overhydration with Irrigating Fluids

Morphological and X-Ray Microanalytical Changes in Mammalian Tissue after Overhydration with Irrigating Fluids

Transient acute liver failure complicating transurethral resection syndrome

Glycine 1.5% for Irrigation Should Be Abandoned

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