Transurethral Resection of the Prostate Syndrome: A Case Report

Abstract

Transurethral resection of the prostate syndrome is a systemic complication caused by excessive absorption of hypotonic electrolyte-free irrigation fluids, that results in hypervolemia, acute dilutional hyponatremia and consequent neurologic and cardiovascular disturbances, that can range from nausea, vomiting, altered mental status and hypertension, to convulsions, visual disturbances, hypotension, pulmonary edema, cardiac arrest, coma and death. It may occur as early as 15 minutes after resection starts or as late as 24 hours after surgery. The majority of cases published describe the occurrence of the syndrome during surgery, in patients under general anesthesia, being the neurologic manifestations masked and the cardiovascular signs predominant. We describe a case diagnosed in the emergency room, that occurred several hours after surgery and presented mostly with neurologic signs. Immediate and aggressive treatment of acute hyponatremia is a major cornerstone of this syndrome management.