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Symptomatology, Pathophysiology and Treatment of the Transurethral Resection of the Prostate Syndrome

1973; Wiley; Volume: 45; Issue: 4 Linguagem: Inglês

10.1111/j.1464-410x.1973.tb12182.x

1365-2176

H. Thomas Norris, Geordis M. Aasheim, Donald J. Sherrard, James A. Tremann,

Anesthesia and Pain Management

Five patients who developed the TURP syndrome during transurethral resection of the prostate absorbed an average of 4.3 litres of urologic irrigating fluid (Cytal). The serum sodium and chloride decreased an average of 36 and 21 mEq/l respectively. The serum Cytal increased an average of 892 mg/100 ml. In comparison minimal changes occurred in the serum values of 8 control patients under-going TURP. Pain in the previously anaesthetised area, seizures, cardiac arrhythmias or heavy prostatic venous bleeding occurred just before the onset of the reaction. Successful treatment included the immediate termination of the resection, control of haemorrhage with Foley catheter and traction, and cessation of all intravenous therapy. The administration of hypertonic saline is contraindicated. Using this method of treatment the serum Cytal levels returned to preoperative values in 5 hours; serum sodium and chloride returned to preoperative levels 24 hours after the resection.