Korean J Anesthesiol.  1996 Jan;30(1):93-97. 10.4097/kjae.1996.30.1.93.

Transurethral Prostatectomy Syndrome

• Park MK
• Kim HJ
• Park KH
• Kim KS

• KMID: 2237823
• DOI: http://doi.org/10.4097/kjae.1996.30.1.93

Abstract

Water intoxication from intravascular absorption of non-electrolyte irrigating fluid is a well-known and often serious complication of TURP(transurethral resection of the prostate). The amount of fluid absorbed is related to the time elapsed, number of venous sinuses opening during resection and the height of the irrigation container. A 78-year-old male patient was performed TURP under spinal anesthesia. During the operation, chest discomfort, peripheral cyanosis, sinus bradycardia, drowsy mental state, hypoxemia, metabolic acidosis, severe hyponatremia, and pulmonary edema appeared. We had made a decision to stop operation immediately and transported to ICU. Endotracheal intubation and controlled mechanical ventilation with positive end expiratory pressure were performed and NaCI 240mEq, NaHCO3 240mEq, furosemide 20mg and 20% mannitol 200ml were injected for four hours. Three hours and forties minutes. after operation, reoperation was done for bleeding control. In consequence of reoperation, the patient began to improve in condition and came to settle in vital signs. We could extubate at dawn on the following day without any problem. We report this case and its management with the review of the relevant literatures.

Keyword

Ions; sodium; hyponatremia; Complications; TURP syndrome; Intoxication; water

MeSH Terms

Absorption
Acidosis
Aged
Anesthesia, Spinal
Anoxia
Bradycardia
Cyanosis
Furosemide
Hemorrhage
Humans
Hyponatremia
Intubation, Intratracheal
Ions
Male
Mannitol
Positive-Pressure Respiration
Pulmonary Edema
Reoperation
Respiration, Artificial
Sodium
Thorax
Transurethral Resection of Prostate*
Vital Signs
Water
Water Intoxication
Furosemide
Ions
Mannitol
Sodium
Water