TURP Syndrome – A Quick Review and Update

Abstract

Transurethral resection of prostate syndrome (TURP-S) is one of the commonest and dreaded complications of urological
endoscopic surgery. It is characterized by cardiocirculatory and neurological changes consequent to acute changes in
intravascular volume and plasma solute concentrations occurring as a result of excess absorption of irrigating fluid. Even in
best of hands, incidence of TURP-S is up to 20% and carries a significant mortality rate - 0.5-5% die perioperatively. It may
occur at any time perioperatively and has been observed as early as few minutes after surgery has started and as late as several
hours after surgery have been completed. Symptoms and signs are varied and unpredictable, and result from fluid overload
and disturbed electrolyte balance and hyponatremia. Treatment is largely supportive and relies on removal of the underlying
cause, and organ and physiological support. Preoperative prevention strategies are extremely important.