Continuous Bladder Irrigation (CBI)

Continuous bladder irrigation delivers sterile solution through the irrigation port of a three-way Foley catheter at a controlled rate to prevent blood clot accumulation, maintain catheter patency, and promote hemostasis in the post-surgical bladder. The irrigating fluid dilutes blood components and mechanically flushes debris through the drainage lumen. Normal saline (0.9% NaCl) is the preferred irrigant for bipolar electrosurgical procedures because it is isotonic and does not cause electrolyte disturbances if absorbed. Monopolar TURP traditionally uses glycine 1.5% or sorbitol-mannitol solutions because they are non-conductive and non-hemolytic; however, these hypotonic solutions create the risk of TURP syndrome when absorbed through open prostatic venous sinuses during resection. Fluid absorption occurs at a rate of approximately 10-30 mL per minute of resection time, and total absorption volumes exceeding 1000-1500 mL significantly increase the risk of symptomatic hyponatremia. TURP syndrome manifests as dilutional hyponatremia (sodium often less than 120 mEq/L), causing cerebral edema, altered mental status, seizures, cardiovascular instability (bradycardia, hypertension progressing to hypotension), nausea, and visual disturbances (glycine is an inhibitory neurotransmitter in the retina). The nurse manages CBI flow titration, performs...