Transurethral resection of the prostate syndrome

Transurethral resection of the prostate syndrome
Synonyms	TURP syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Hyponatremia, nausea, vomiting, confusion, hypertension, bradycardia, visual disturbances
Complications	Seizures, coma, cardiac arrest
Onset	During or shortly after transurethral resection of the prostate
Duration	Variable, depending on severity and treatment
Types	N/A
Causes	Absorption of irrigation fluid during transurethral resection of the prostate
Risks	Large prostate size, prolonged surgery time, use of hypotonic irrigation fluids
Diagnosis	Clinical evaluation, serum sodium measurement
Differential diagnosis	Hyponatremia from other causes, sepsis, anesthesia-related complications
Prevention	Use of isotonic irrigation fluids, limiting surgery time, monitoring fluid absorption
Treatment	Fluid restriction, diuretics, hypertonic saline administration
Medication	N/A
Prognosis	Good with prompt recognition and treatment
Frequency	Rare with modern techniques
Deaths	N/A

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