How does TURP cause hyponatremia?

How does TURP cause hyponatremia?

Excessive absorption of the irrigation solutions used during TURP, which are highly hypotonic can cause dilutional hyponatremia and hypo-osmolality resulting in severe neurological symptoms. Hyponatremia symptoms do not generally manifest until serum sodium concentrations are below 120 mmol/l.

Why does TURP cause bradycardia?

Complications of Transurethral Surgery Reflex bradycardia occurs in response to the increased blood pressure. T-wave depression on the ECG is caused by glycine in the irrigating fluid. Hyponatremia is yet another sign of hypotonic irrigant absorption (Table 210-1).

What are the complication of TURP?

The major late complications are urethral strictures (2.2-9.8%) and bladder neck contractures (0.3-9.2%). The retreatment rate range is 3-14.5% after five years. Conclusions: TURP still represents the gold standard for managing benign prostatic hyperplasia with decreasing complication rates.

What is the cause of TURP syndrome?

Transurethral resection of prostate (TURP) syndrome is a systemic complication of transurethral resection of the prostate or bladder tumours, caused by excessive absorption of electrolyte-free irrigation fluids.

How do you treat TUR syndrome?

Methods to lower the uptake of irrigating fluid are widely used and probably reduce the incidence of the TUR syndrome. However, patient safety can be guaranteed only if the absorption is monitored. An irrigating fluid containing tracer amounts of ethanol can be used for this purpose.

What causes TUR syndrome?

Abstract. The transurethral resection syndrome (“TUR syndrome”) is caused by absorption of electrolyte-free irrigating fluid, and consists of symptoms from the circulatory and nervous systems.

Is hypertension a symptom of TURP syndrome?

Just after the end of the surgery, the patient presented signs of TURP syndrome with bradycardia, arterial hypertension, hypoxemia and dizziness-confusion. The electrolytes analysis revealed an acute hyponatremia (sodium concentration 120.6 mmol/L) and hyperkalemia (potassium concentration 6.48 mmol/L).

What is TURP syndrome of the prostate?

Abstract Transurethral resection of prostate (TURP) syndrome is a complication characterised by symptoms changing from an asymptomatic hyponatremic state to convulsions, coma and death due to absorption of irrigation fluid during TURP.

What causes transurethral resection syndrome during TURP?

Transurethral resection syndrome during transurethral resection of the prostate (TURP) results from excessive absorption of electrolyte-free irrigation fluids causing acute hypervolemia and hyponatremia [6, 7].

What is the incidence of TURP syndrome in the US?

It is the most common benign enlargement of the prostate.4Its incidence is about 0–1.1%.10TURP syndrome can cause a wide variety of symptoms that include asymptomatic hyponatremia, ECG changes, fatigue, vomiting, confusion, visual loss, coma and death.9

What is the electrolyte analysis for TURP syndrome?

The TURP syndrome was subsequently confirmed by an immediately electrolyte analysis revealed a decrease in serum sodium concentration from 145 mmHg to 125 mmHg. Hypertonic saline solution 3% at a rate of 50 ml/h was started. The patient was transfused with 2 units blood. Furosemide wasn’t given.

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