Transurethral resection of the prostate syndrome: Difference between revisions

Revision as of 15:48, 9 February 2025

Transurethral Resection of the Prostate Syndrome

Transurethral resection of the prostate syndrome (TURP syndrome) is a rare but serious complication that can occur during or after a transurethral resection of the prostate (TURP) procedure. TURP is a surgical procedure used to treat urinary problems due to an enlarged prostate.

Pathophysiology

TURP syndrome is primarily caused by the absorption of irrigation fluids used during the procedure. During TURP, a resectoscope is inserted through the urethra to remove prostate tissue. To maintain a clear field of vision, continuous irrigation with fluids is necessary. If these fluids are absorbed into the bloodstream, it can lead to a condition known as water intoxication or dilutional hyponatremia.

Symptoms

The symptoms of TURP syndrome can vary but often include:

Nausea and vomiting
Confusion or altered mental status
Hypertension or hypotension
Bradycardia
Visual disturbances
Seizures
Pulmonary edema

Diagnosis

Diagnosis of TURP syndrome is based on clinical symptoms and laboratory findings. Blood tests may reveal hyponatremia, hypo-osmolality, and other electrolyte imbalances. Monitoring of fluid balance and electrolytes is crucial during and after the procedure.

Treatment

The treatment of TURP syndrome involves:

Discontinuation of the irrigation fluid
Administration of diuretics to promote diuresis
Intravenous administration of hypertonic saline to correct hyponatremia
Monitoring and supportive care in a hospital setting

Prevention

Preventive measures include:

Using isotonic or near-isotonic irrigation solutions
Limiting the duration of the procedure
Monitoring fluid absorption and electrolyte levels

Related pages

References

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-'''Transurethral Resection of the Prostate Syndrome''' ('''TURP Syndrome''') is a rare but potentially life-threatening complication that can occur during or after a [[Transurethral Resection of the Prostate]] (TURP) procedure. TURP is a common surgical procedure used to treat [[Benign Prostatic Hyperplasia]] (BPH), a condition characterized by the enlargement of the prostate gland which can lead to difficulty in urination.
+== Transurethral Resection of the Prostate Syndrome ==
-==Overview==
+'''Transurethral resection of the prostate syndrome''' ('''TURP syndrome''') is a rare but serious complication that can occur during or after a transurethral resection of the prostate (TURP) procedure. TURP is a surgical procedure used to treat urinary problems due to an enlarged prostate.
-TURP syndrome is primarily caused by the absorption of excessive irrigation fluid used during the TURP procedure into the systemic circulation. This can lead to a range of clinical manifestations including [[Hyponatremia]] (low sodium levels in the blood), fluid overload, [[Hypertension]] (high blood pressure), [[Pulmonary Edema]] (fluid accumulation in the lungs), and in severe cases, [[Cerebral Edema]] (swelling of the brain), which can be fatal.
-==Symptoms==
+== Pathophysiology ==
-Symptoms of TURP syndrome may include:
+TURP syndrome is primarily caused by the absorption of irrigation fluids used during the procedure. During TURP, a resectoscope is inserted through the urethra to remove prostate tissue. To maintain a clear field of vision, continuous irrigation with fluids is necessary. If these fluids are absorbed into the bloodstream, it can lead to a condition known as water intoxication or dilutional hyponatremia.
+== Symptoms ==
+The symptoms of TURP syndrome can vary but often include:
 * Nausea and vomiting
-* Confusion or mental status changes
+* Confusion or altered mental status
 * Hypertension or hypotension
-* Bradycardia (slow heart rate)
+* Bradycardia
 * Visual disturbances
-* Muscle cramps or weakness
 * Seizures
+* Pulmonary edema
-==Pathophysiology==
+== Diagnosis ==
-The pathophysiology of TURP syndrome involves the absorption of large volumes of irrigation fluid into the venous system through open prostatic veins during surgery. The commonly used irrigation fluid is hypotonic, which can lead to a dilutional hyponatremia and a shift of water into cells, causing cellular edema.
+Diagnosis of TURP syndrome is based on clinical symptoms and laboratory findings. Blood tests may reveal hyponatremia, hypo-osmolality, and other electrolyte imbalances. Monitoring of fluid balance and electrolytes is crucial during and after the procedure.
-==Diagnosis==
-Diagnosis of TURP syndrome is primarily clinical, based on the presentation of symptoms and the timing of their occurrence during or after a TURP procedure. Laboratory tests showing hyponatremia and other electrolyte imbalances can support the diagnosis.
-==Treatment==
+== Treatment ==
-Treatment of TURP syndrome focuses on correcting the fluid and electrolyte imbalances. This may involve:
+The treatment of TURP syndrome involves:
-* Restriction of fluid intake
+* Discontinuation of the irrigation fluid
-* Administration of hypertonic saline to correct hyponatremia
+* Administration of diuretics to promote diuresis
-* Diuretics to manage fluid overload
+* Intravenous administration of hypertonic saline to correct hyponatremia
-* Supportive care for other symptoms as needed
+* Monitoring and supportive care in a hospital setting
-In severe cases, intensive care may be required to manage the complications of the syndrome.
+== Prevention ==
+Preventive measures include:
+* Using isotonic or near-isotonic irrigation solutions
+* Limiting the duration of the procedure
+* Monitoring fluid absorption and electrolyte levels
-==Prevention==
+== Related pages ==
-Preventive measures for TURP syndrome include careful monitoring of fluid balance during the procedure, using minimally invasive surgical techniques to reduce the risk of fluid absorption, and limiting the duration of the procedure to reduce exposure to irrigation fluids.
+* [[Transurethral resection of the prostate]]
+* [[Benign prostatic hyperplasia]]
+* [[Hyponatremia]]
-==Conclusion==
+== References ==
-TURP syndrome is a serious complication of the TURP procedure, but with appropriate preventive measures and prompt recognition and treatment of symptoms, the risks can be minimized. Awareness and understanding of TURP syndrome among healthcare providers are essential for ensuring patient safety during and after TURP procedures.
+{{Reflist}}
 [[Category:Urology]]
-[[Category:Medical conditions]]
+[[Category:Syndromes]]
-{{medicine-stub}}