Epinephrine-assisted continuous bladder irrigation after transurethral resection of the prostate: a randomized controlled trial

Saraj Choeypunt; Satit Siriboonrid; Nattapong Binsri; Vittaya Jiraanankul; Weerayut Wiriyabanditkul; Thanisorn Pattanasuwan; Phatsinee Likitpanpisit; Sarayut Kanjanatarayon

doi:10.32604/cju.2026.081532

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Epinephrine-assisted continuous bladder irrigation after transurethral resection of the prostate: a randomized controlled trial

Saraj Choeypunt^*, Satit Siriboonrid, Nattapong Binsri, Vittaya Jiraanankul, Weerayut Wiriyabanditkul, Thanisorn Pattanasuwan, Phatsinee Likitpanpisit, Sarayut Kanjanatarayon^*
Division of Urology, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
* Corresponding Author: Saraj Choeypunt. Email: email ; Sarayut Kanjanatarayon. Email: email

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.081532

Received 14 May 2026; Accepted 08 July 2026; Published online 17 September 2026

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Abstract

Objectives: Benign prostatic obstruction (BPO) is highly prevalent among aging men. Transurethral resection of the prostate (TUR-P) remains the gold standard therapy; however, postoperative complications such as hematuria and clot retention can impair recovery, prolong hospitalization, and increase the risk of transfusion or infection. This study aimed to evaluate the effect of continuous bladder irrigation (CBI) with epinephrine (CBI-E) on the time to cessation of bladder irrigation following TUR-P, as well as its impact on postoperative outcomes, including length of hospital stay, hematocrit change, irrigation volume, and complications. Methods: This single-center randomized controlled trial was conducted between March 2024 and January 2025. Male patients aged 50–80 years undergoing TUR-P for BPO were randomized to receive postoperative bladder irrigation with either CBI with epinephrine (CBI-E group) or CBI with normal saline (CBI group). The primary outcome was time to cessation of bladder irrigation. Secondary outcomes included hemodynamic parameters, hematocrit change, irrigation volume, postoperative complications, and length of hospital stay. Results: Eighty-five patients were analyzed (CBI-E group, n = 43; CBI group, n = 42). Time to cessation of bladder irrigation was significantly shorter in the CBI-E group (p < 0.001). The CBI-E group also had a shorter length of hospital stay, while hematocrit change and transfusion rates were comparable. No significant hemodynamic instability or serious epinephrine-related adverse events were observed. Conclusion: CBI-E following TUR-P appears to be safe and effectively reduces the time to cessation of bladder irrigation. It is also associated with a shorter hospital stay without increasing postoperative complications.