Severe form of transurethral resection of the prostate syndrome: Case report (TURP syndrome)

Abstract

Introduction: Transurethral resection of the prostate (TURP) syndrome is iatrogenic state of water intoxication after transurethral resection of the prostate, an endoscopic procedure in urology. Neurological changes, heart failure and respiratory failure, followed with hyper or hypotension and hypoxia and acidemia, are dominant signs in clinical presentation of the TURP syndrome. For the last decade, better understanding of TURP syndrome pathophysiology and development of preventive measures, led to decrease incidence of the TURP syndrome. The present incidence of TURP syndrome is below 1 %. Case report: We are presenting case of severe TURP syndrome developed during endoscopic two hours long urologie procedure. TURP syndrome was manifested with serious neurologic disturbance which has expanded to coma and epileptic seizures, followed with hemodynamic instability requiring inotropic and vasopressor support. Severe hyponatremia (serum Na+102 mmol/l) was dominant biochemical finding. We are presenting therapy approach to the patient with severe form of TURP syndrome followed by patient health condition improvement. Conclusion: TURP syndrome is iatrogenic potentially life threatening condition, which may be presented during or after intervention. With constant patient monitoring symptoms of TURP syndrome can be early recognized and with adequate therapy potential complications can be avoided.

Keywords

• transurethral resection of the prostate
• hyponatremia
• hypo-osmolality
• water intoxication