TROPONIN T AND N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE CHANGES IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE

Abstract

No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Nov 2005TROPONIN T AND N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE CHANGES IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE RAMASWAMY MANIKANDAN, CALVIN NATHANIEL, PHILLIP LEWIS, RICHARD J. BROUGH, ADEBANJI ADEYOJU, STEPHEN C.W. BROWN, PATRICK H. O’REILLY, and GERALD N. COLLINS RAMASWAMY MANIKANDANRAMASWAMY MANIKANDAN , CALVIN NATHANIELCALVIN NATHANIEL , PHILLIP LEWISPHILLIP LEWIS , RICHARD J. BROUGHRICHARD J. BROUGH , ADEBANJI ADEYOJUADEBANJI ADEYOJU , STEPHEN C.W. BROWNSTEPHEN C.W. BROWN , PATRICK H. O’REILLYPATRICK H. O’REILLY , and GERALD N. COLLINSGERALD N. COLLINS View All Author Informationhttps://doi.org/10.1097/01.ju.0000177496.51808.4aAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated whether transurethral resection of the prostate (TURP) caused subclinical myocardial damage or cardiac dysfunction by measuring troponin T (Trop T) and N-terminal pro-brain natriuretic peptide (pro-BNP). Materials and Methods: A total of 52 consenting patients took part in this study. All had a detailed medical history including cardiac history taken. On the day of the operation all patients had troponin T, pro-BNP, full blood count and urea, electrolytes and creatinine measured preoperatively. A preoperative and postoperative electrocardiogram was performed. Patients in renal failure were excluded from analysis. During the operations factors such as blood loss, operative time, tissue resected and fluid absorption were monitored. On postoperative day 1 all the previously mentioned tests were repeated. Results: Mean patient age was 71 years (range 52 to 85). Eight patients had a history of associated cardiac problems. Mean preoperative and postoperative hemoglobin were 14.1 gm/dl (range 10.5 to 17) and 13.3 gm/dl (range 9.9 to 16.2), respectively. None of the patients had significant (greater than 1,000 ml) fluid absorption during TURP, which was calculated using ethanol tagged glycine. Mean blood loss measured with a photometer was 129.7 ml (range 0 to 1,800). Mean operative time was 28.4 minutes (range 5 to 50) and mean weight of prostatic tissue resected was 15.2 gm (range 1 to 47). Preoperative Trop T was less than 0.01 mcg/ml in all patients and mean pro-BNP was 39.2 pg/ml (range 0.5 to 866). Postoperative Trop T was less than 0.01 mcg/ml in all but 1 patient who experienced chest pain after TURP and had an increased Trop T (0.28 mcg/ml). Mean postoperative pro-BNP was 54.57 pg/ml (range 1 to 679). A total of 37 patients had an increase in pro-BNP which was still within the reference range for the age group. There were no significant electrocardiogram changes postoperatively. The Trop T changes were not statistically significant (Wilcoxon sign ranked test p=0.31) although they may be clinically significant. Conclusions: Our study indicates that in patients with no prior cardiac history TURP does not cause myocardial damage indicated by nonincrease of Trop T. There are slight increases in pro-BNP after TURP in some patients although the exact clinical significance is uncertain. References 1 : Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. N Engl J Med1989; 320: 1120. Google Scholar 2 : Mortality after transurethral and open prostatectomy in Scotland.. Br J Urol1996; 77: 547. 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Google Scholar From the Department of Urology (RM, CN, RJB, AA, SCWB, PHO, GNC) and Department of Cardiology (PL), Stepping Hill Hospital, Stockport, United Kingdom© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 174Issue 5November 2005Page: 1892-1895 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordstransurethral resection of prostate, mortalitytroponin T, prostatic hyperplasianatriuretic peptide, brainMetricsAuthor Information RAMASWAMY MANIKANDAN More articles by this author CALVIN NATHANIEL More articles by this author PHILLIP LEWIS More articles by this author RICHARD J. BROUGH More articles by this author ADEBANJI ADEYOJU More articles by this author STEPHEN C.W. BROWN More articles by this author PATRICK H. O’REILLY More articles by this author GERALD N. COLLINS More articles by this author Expand All Advertisement PDF downloadLoading ...