The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

Ficarra, V.; Bartoloni, A; Tallarigo, C.; Malossini, G.

doi:10.1159/000056589

Cited by 20 publications

(17 citation statements)

References 30 publications

(40 reference statements)

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“…It is conceivable that severe acidosis, which developed at the early stage of surgery, was probably induced by the dilutional acidosis (16) rather than lactic acidosis because the serum lactate increased later stage of surgery. According to intravenous furosemide (20-100 mg) therapy (6) for dilutional hyponatremia due to hypervolemia in the early stage of TURP syndrome, in present patient, furosemide was administered in an attempt to induce diuresis. However, the serum sodium level persisted at <100 mEq/L.…”

Section: Discussionmentioning

confidence: 96%

“…In the present patient, adhesiolysis of uterine synechiae opened the uterine vein. Hydrostatic pressure increased when the irrigating fluid bag was placed 75 cm higher than the recommended height of 60 cm above the operating table (6), thus leading to rapid absorption of a large amount of irrigating fluid. It is conceivable that rapid absorption of irrigating fluid may induce TURP syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Severe Hypocalcemia Caused by Absorption of Sorbitol-Mannitol Solution during Hysteroscopy

2009

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Hysteroscopic procedure can be complicated by intravascular absorption of irrigating fluid. The clinical features of this complication are similar to transurethral resection of the prostate (TURP) syndrome. There have been few reports on hypocalcemia during endoscopoic surgery and clinical implications of hypocalcemia in TURP syndrome have been underestimated. We report a case of TURP syndrome association with a decreased ionized calcium concentration of 0.53 mM/L after the absorption of a large amount of sorbitol-mannitol solution during hysteroscopy. The hypotension which occurred in TURP syndrome did not respond to vasopressor and inotropic agent but responded to the administration of calcium. This case was also accompanied by hyponatremia, hyperglycemia and lactic acidosis through the metabolism of sorbitol.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Severe Hypocalcemia Caused by Absorption of Sorbitol-Mannitol Solution during Hysteroscopy

2009

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“…The studies cited [28,29,30,31] are relatively old and all refer to the absorption volume of electrolyte-free solution. With the complexity of the transurethral resection syndrome that can occur when electrolyte-free irrigation fluid is used, it is very difficult to estimate the absorption volume below, which can be safely assumed that electrolyte-related disturbances will not arise.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Procedure-Specific Irrigation-Fluid Absorption in Transurethral Therapy of Lower Urinary Tract Syndrome, Using Ethanolic Saline and Breath Alcometry

Porsch

Mittelstädt²,

Wendler³

et al. 2016

Urol Int

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Introduction: Transurethral resection risks excessive absorption of irrigating fluid with potentially severe or life-threatening consequences. We determined the amount of absorbed saline irrigation fluid during photoselective vaporisation of the prostate (PVP) and bipolar transurethral resection of the prostate (bTURP). Patients and Methods: Patients at our institution treated by one of these methods were monitored by the alcometric method: ethanol is added to the irrigation fluid and blood alcohol is measured with a breathalyser. Various possible correlations were investigated. Results: Data from 71 patients (36 PVP, 35 bTURP) were analysed. Detection of any absorption was more frequent under bTURP (71% of patients) than under PVP (39%; p = 0.006). Absorption in the volume range 500-1,000 ml was conspicuously more frequent in the bTURP procedure than in PVP. Conclusions: Presence of absorption was more frequent under bTURP than under PVP. However, high-volume absorption was more frequent during bTURP than in PVP.

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“…Ideally, TURP should be reserved for prostate weighing below 60 grammes. [1][2][3] As this is a disease of old age, so a large number of these patients also suffer from diseases of other systems, which add to increased morbidity and mortality. Myocardial ischaemia may occur in up to 25% of these cases whereas 1-3% patients may develop myocardial infarction during surgery.…”

Section: Introductionmentioning

confidence: 99%

Prospective observational study on caudal epidural block for transurethral resection of prostate in patients with comorbidities

Paudel¹,

Paudel²,

Das³

2016

J. Soc. Anesth. Nep.

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Background: The most important goal of anaesthesia for geriatric patients with comorbid diseases is to maintain normal homoeostasis of different systems during and after surgery. This prospective study was conducted to evaluate the success rate and associated complications of the caudal epidural block for transurethral resection of prostate in elderly patients with comorbid diseases.Methods: This is a prospective study of a cohort of 100 elderly patients posted for transurethral resection of prostate with comorbid diseases belonging to American Society of anaesthesiologists physical status II, III and IV over a period of 1 year from April 2015 to April 2016. Standard recommended technique for caudal epidural block was followed. Time of onset, spread, duration of analgesia, intensity of block, complications, and unwanted effects were noted.Results: The mean age was 73.5+-7.69. Eighty-two percent patients belonged to ASA III and IV grade. The majority (87%) had excellent to a good quality of anaesthesia with no motor block. 83% of patients had the onset of analgesia between 5-15 minutes and 78% had a duration between 90-130 minutes. Three patients had patchy analgesia and they were considered as a failure. No death was encountered in the study.Conclusion: Caudal epidural block is a safe, effective anaesthetic technique for transurethral resection of the prostate in elderly with comorbid diseases of other systems.

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The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

Cited by 20 publications

References 30 publications

Severe Hypocalcemia Caused by Absorption of Sorbitol-Mannitol Solution during Hysteroscopy

Severe Hypocalcemia Caused by Absorption of Sorbitol-Mannitol Solution during Hysteroscopy

Measurement of Procedure-Specific Irrigation-Fluid Absorption in Transurethral Therapy of Lower Urinary Tract Syndrome, Using Ethanolic Saline and Breath Alcometry

Prospective observational study on caudal epidural block for transurethral resection of prostate in patients with comorbidities

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