Incidence, clinical manifestations and outcome of TUR (transurethral resection) syndrome in patients undergoing TURP under spinal anaesthesia: results from clinical observations in a cohort of 50 patients at a tertiary care centre in North India

Abstract

Background: ‘TUR syndrome’ is clinically detectable in 2% of patients undergoing an otherwise safe operation. Currently, spinal anaesthesia is the most widely anaesthetic technique for TURP as it is easier to detect signs of TUR syndrome in an awake patient. This study aimed at looking at the clinical spectrum and outcomes of TUR syndrome in patients undergoing TURP under spinal anaesthesia.Methods: This clinical study was conducted over a period of 6 months in the departments of anesthesiology and urology at the Christian medical college and hospital Ludhiana in a cohort of 50 male patients electively admitted for TURP under spinal block belonging to ASA I or II groups. Patients received intermittent irrigation with 1.5% glycine, and monitored for TUR symptoms and electrolyte estimations perioperatively.Results: In our study the incidence of TURP syndrome was 10 %. Under spinal block clinical manifestations along with serum sodium values monitored perioperatively helped diagnose and manage the patients. All patients successfully completed resection, with no mortality related to TURP syndrome.Conclusions: In patients undergoing transurethral resection of prostate under spinal anaesthesia, monitoring clinical symptoms for the rare TURP syndrome and additional serum sodium levels act as an adjunct in diagnosis. In both situations diagnosis and early intervention prevents extreme neurological symptoms and reduces mortality.

Clinical profile and outcomes of patients with clinical benign prostate hyperplasia treated by trans urethral resection of prostate at Bugando Medical Centre, Mwanza, Tanzania

“…Additionally 7(10.6%) had transient incontinence on catheter removal, which on follow up visits they all got better, this may be because of the oedema of the sphincter post TURP which explains its disappearance as the oedema subsides. This is similar to findings by other studies [17,29] A total of 16 (6.4%) of the participants needed blood transfusion, this was higher almost approaching that of open prostatectomy. Most 13(82.3%) of those who needed blood had prostate >80grams.…”

“…Although this procedure is a gold standard for management of BPH, it is associated with other complications other than TUR syndrome which occurs in up to 10% of patients [17]. These includes Bleeding requiring blood transfusion, capsular perforation, total incontinence, failure to void (18) and perioperative deaths [19].…”

Two-Stage TURP as an Option for Treatment of Large Prostates in Resource Poor Environments

“…None of the patients in the index study had TUR syndrome similar to what was found by earlier studies [15], [23]. This, however, is at variance with the 10% and 23.5%incidence rates of TUR syndrome documented by George et al [24] in India and Nakahira et al [22] in Japan. Incidence rates of 2%, 3.2% and 4.8% were documented by Persu et al [17] in Romania, McGowan-Smyth et al [25] in the United Kingdom and Chukwujama et al [19] in Nigeria, respectively.…”