The role of lubrication in transurethral electrical resection

Transurethral resection inevitably leads to thermal as well as mechanical stress on the urethra, and it is important to reduce both. This can be achieved by using a suitable lubricant. Measurements in saline irrigation fluid as long as 30 years ago showed that the distribution of high-frequency current in the region of the urethra during transurethral electrical resection depends on the different resection systems, i.e. the varying placement of the neutral electrode. Application of a lubricant with appropriate conductivity makes it possible to avoid dangerous current surges in the region of the urethra. When it is used for reduction of the mechanical stress on the urethra, the consistency and amount of the lubricant used and also the frequency of application are important. Theoretically, even in the case of the so-called bipolar transurethral resection procedure in saline used today, the possibility that the electric current will cause thermal damage to the urethra is as great as when a conventional monopolar resection procedure using nonconductive irrigation fluid is performed.