Transurethral resection of the prostate syndrome

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

• Transurethral resection of the prostate
• Benign prostatic hyperplasia
• Hyponatremia