Intravascular Complications of Transurethral Resection of the Prostate

Bird, David; Slade, N.; Feneley, R. C. L.

doi:10.1111/j.1464-410x.1982.tb13593.x

Cited by 24 publications

(16 citation statements)

References 8 publications

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“…There is also a reduction in plasma chloride, potassium, calcium and magnesium levels and an increase in serum bicarbonate (Malone et at., 1986). If the operation is performed under regional anaesthesia, changes in mental state ranging from confusion to coma may occur (Still and Modell, 1973;Bird et a/., 1982) and if performed under general anaesthesia, recovery from the effects of anaesthesia may be delayed (Osborn et a/., 1980). These are mainly due to cerebral oedema caused by the shift of fluid from intravascular to intercellular space.…”

Section: Pathological Sequelaementioning

confidence: 99%

Fluid Absorption During Urological Endoscopy

Rao¹

1987

British Journal of Urology

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Transurethral prostatectomy (TURP) and, more recently, percutaneous nephrolithotomy and endoureteric procedures for stones in the kidney and ureter have justifiably become popular because of the many advantages offered by these less invasive procedures. Any surgical operation has its attendant complications and absorption of irrigant fluid is a major and potentially fatal complication of all of these endoscopic techniques. This review examines the incidence, the causes and the pathological sequelae of excessive fluid absorption and suggests some ways to prevent it.

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Section: Pathological Sequelaementioning

confidence: 99%

Fluid Absorption During Urological Endoscopy

Rao¹

1987

British Journal of Urology

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“…Hyponatremia can be developed as a result of absorption of irrigation fl uids without electrolytes as well as osmotic diuresis induced by glycine [20][21][22] . In general, symptoms do not appear before the Na level drops below 125 mEq/ml [23] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Transurethral Resection and Plasmakinetic Transurethral Resection Applications with Regard to Fluid Absorption Amounts in Benign Prostate Hyperplasia

et al. 2006

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Introduction: We compare the absorption of irrigant fluid during gyrus plasmakinetic transurethral prostatectomy (PK-TURP) and transurethral resection of the prostate (TURP). Patients and Methods: 42 patients with clinical benign prostatic hyperplasia were randomly assigned to undergo PK-TURP or TURP. In the PK-TURP group 0.9% NaCl was used as an irrigation fluid and 1.5% glycine in the TURP group. By adding ethanol to the irrigation fluids 1% ethanol-containing solutions were formed. All operations were carried out under spinal anesthesia and alcohol concentration of the ventilated air measurements were made just at the beginning of the operation, every 10 min peroperatively and at the end of the operation by using an alcoholmeter. Results: There was no difference in age, prostate volume and the length of operation time in either group. In both groups, the estimated absorbed fluid volume increased with the duration of surgery (p < 0.05). The difference between mean fluid absorption during PK-TURP and during TURP was the statistically significant (p < 0.01). Conclusion: PK-TURP operation causes lesser absorption of the irrigation fluid than the TURP operation. The lesser absorption of irrigation fluid and using saline instead of glycine decreases the risk of TUR syndrome.

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“…TURS manifests as shock during surgery and by next morning it manifests as HN encephalopathy coma [9]. TURS may be mistaken for other recognized shocks such as septicaemic [10], hemorrhagic [11][12][13] and cardiogenic [14,15] shock. VOS 2 may complicate all types of shocks during fluid therapy and the transition is seamless and hard to detect.…”

Section: Literature Reviewmentioning

confidence: 99%

Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia

Pindoria¹,

Ghanem²,

Ghanem³

et al. 2017

Integr Mol Med

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The transurethral prostatectomy syndrome (TURS) is defined as severe vascular hypotension reaction that complicates endoscopic surgery as a result of massive irrigating fluid absorption causing severe acute dilution hyponatraemia (HN) of <120 mmol/l. The vascular shock is usually mistaken for one of the recognized shocks and Volumetric Overload Shock type 1 (VOS1) is overlooked making Volumetric Overload Shock Type 2 (VOS2) unrecognizable. VOS1 is induced by the infusion of 3.5-5 liters of sodium-free fluids and is known as TURS or HN shock. VOS2 is induced by 12-14 liters of sodium-based fluids and is known as the adult respiratory distress syndrome. The most effective treatment for VOS1 and VOS2 is hypertonic sodium of 5% NaCl or 8.4% Sodium Bicarbonate. The literature is reviewed and the underlying patho-etiology is discussed. As Starling's law for the capillary-interstitial fluid transfer proved wrong an alternative mechanism was found by studying the hydrodynamics of the porous orifice (G) tube. Incorporating the G tube in a chamber (C), representing the interstitial space surrounding a capillary, demonstrated a rapid dynamic magnetic field-like fluid circulation between the C and G tube lumen. The G-C phenomenon is autonomous having both filtration and absorption forces making a true replacement for Starling's law.

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Intravascular Complications of Transurethral Resection of the Prostate

Cited by 24 publications

References 8 publications

Fluid Absorption During Urological Endoscopy

Fluid Absorption During Urological Endoscopy

Comparison of Transurethral Resection and Plasmakinetic Transurethral Resection Applications with Regard to Fluid Absorption Amounts in Benign Prostate Hyperplasia

Volumetric overload shocks in the patho-etiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia

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