Transurethral resection syndrome during transurethral resection of the prostate turp is a systemic complication 1,2 caused by excessive absorption of electrolyte free irrigation fluids. Transurethral resection of the prostate turp syndrome is a rare but potentially fatal syndrome. The treatment of turp syndrome is largely supportive, with early. Transurethral resection tur syndrome occurs in about 2 out of 100 men who have turp. Trans urethral resection of prostate turp syndrome is one of the commonest. The posttransurethral resection of prostate syndrome. Transurethral resection how is transurethral resection.
Volumetric overload shock vos is a condition induced by large fluid infusions in a short time and is of two types. Turp is a type of surgery used to treat a benign enlargement of the prostate, also known as bph benign prostatic hyperplasia. Consequences of fluid absorption during transurethral. Its a type of surgery used to take samples of tissue from inside your bladder to find out if you have. The treatment of the tur syndrome consists of general life support and in. Transurethral resection syndrome tur syndrome in contemporary series, the risk of tur syndrome after turp has decreased to syndrome is characterized as a dilutional hyponatremia serum sodium free surgical method david m. In select patients, officebased fulguration of small tumors allows control of lowrisk lesions without incurring the. An adequate view of the prostate during transurethral prostatectomy turp requires the use of an irrigating fluid. Transurethral resection tur syndrome is an iatrogenic form of water intoxication, a combination of. Jan 09, 20 transurethral resection of prostate turp syndrome is a systemic complication of transurethral resection of the prostate or bladder tumours, caused by excessive absorption of electrolyte free irrigation fluids. Transurethral resection an overview sciencedirect topics. Because the sodium from intravascular space is dialyzed to intraperitoneal. Hyponatraemia following transurethral resection of the prostate. Apr 23, 2014 transurethral resection of the prostate turp involves the risk of transurethral resection tur syndrome owing to hyponatremia.
The transurethral resection syndrome tur syndrome is caused by absorption of. Turp remains the surgical gold standard for the treatment of benign prostatic hyperplasia bph, which causes urinary obstruction and increases the. Transurethral resection of the prostate turp is a standard surgical procedure for the management of benign prostatic obstructions. Irrigation fluid type, duration of operation, and weight of resected mass have been evaluated as risk factors for tur syndrome. Krames online transurethral resection of the prostate turp. The transurethral resection of the prostate turp syndrome and acute dilutional hyponatraemia hn.
Stop procedure, 20 mg furosemide iv, free water restrict, hypertonic. The surgeon will insert an instrument up the penis through the urethra and cut away the prostate tissue until the passage is well open. The transurethral resection syndrome tur syndrome is caused by absorption of electrolyte. Endoscopic treatment with transurethral resection of bladder tumor turbt is the firstline treatment to diagnose, stage, and treat visible tumors. Definition of transurethral resection in the financial dictionary by free online english dictionary and encyclopedia. Transurethral resection of the prostate turp syndrome is a rare but potentially lifethreatening complication of a transurethral resection of the prostate procedure. Transurethral resection of the prostate euacme pdf. Tur syndrome was defined as evidence of a central nervous system. As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection.
Transurethral resection must be performed very carefully in this region to avoid perforation of the prostatic capsule, especially if this part of the prostate is approached at the beginning of the intervention. Transurethral resection of the prostate, or turp, is an effective treatment to relieve bph symptoms and improve urinary flow. Download transurethral resection of the prostate euacme book pdf free download link or read online here in pdf. The purpose of the present study was to identify risk factors related to tur syndrome in the elderly. The transurethral resection syndrome hahn 1991 acta.
A 78yearold man with prostatic hypertrophy was scheduled for transurethral resection of the prostate under spinal anesthesia. Nonconductive irrigation fluid is required during the use of monopolar electric resectoscope to clear the operating field. Transurethral resection of prostate turp syndrome is a systemic complication of transurethral resection of the prostate or bladder tumours, caused by excessive absorption of electrolyte free irrigation fluids. Transurethral resection syndrome detected and managed using. This syndrome may potentially cause neurologic disturbance, pulmonary edema, cardiovascular compromise, and death. Read online transurethral resection of the prostate euacme book pdf free download link book now. Transurethral resection of the prostate euacme pdf book. Reduced risk of postoperative blood transfusion because of intraoperative bleeding. Transurethral resection of the prostate syndrome wikipedia. However, tur of hunner lesion is not superior in recurrence free time to tuc, but may have a higher chance to develop bladder injury. The claimed benefits of the turis system for transurethral resection of the prostate presented by the company were. It is used to treat benign prostatic hyperplasia bph.
The symptoms of tur syndrome include mental confusion, nausea, vomiting, high blood pressure, slowed heartbeat. Introduction turp syndrome turp transurethral resection of the prostate syndrome is an iatrogenic complication caused by absorption of the irrigating fluid which is used to distend the bladder during surgery. A case of severe postturp syndrome due to the absorption of hypotonic glycine irrigant is. Over 400 000 turp procedures occur each year with turp syndrome occurring in 1015% of cases, and an associated mortality of 0. Whenever irrigation fluid enters the intravascular space, dangerous complications can arise. Transurethral resection financial definition of transurethral.
Transurethral resection of the prostate turp series home medical encyclopedia transurethral resection of the prostate transurethral resection of the prostate transurethral resection of the prostate turp is surgery to remove the inside part of the prostate gland in order to treat an enlarged prostate. Absorption of large volumes of irrigation fluid during transurethral resection of the prostate turp can produce hyponatremia, coma, blindness, and cardiorespiratory depression. Transurethral resection of the prostate turp is a surgery used to treat urinary problems that are caused by an enlarged prostate. Electrolytefree hypotonic solutions such as glycine, mannitol, and sorbitol. Cumes, md a transurethral resection of the prostate turp is performed when patients, usually elderly men with enlarged, noncancerous prostate glands, find urination increasingly difficult as they age. The transurethral resection syndrome, acta anaesthesiologica. It is situated at the base of the bladder and surrounds the urethra tube. Transurethral resection syndrome detected and managed. Transurethral resection of the prostate the free dictionary. In this work, we describe a case of intravesical explosion during turp, followed by fatal transurethral resection syndrome, in a patient with bph. In select patients, officebased fulguration of small tumors allows control of lowrisk lesions without incurring the cost and inefficiencies of the operating room.
Turp syndrome treatment can be divided into management of volume. Transurethral resection of the prostate is frequently complicated by absorption of the irrigating fluid which is used to distend the bladder during surgery, j 3 because of this absorption, there are. Transurethral resection syndrome after bladder perforation. The transurethral resection of prostate turp syndrome.
If you have a bladder tumor, your doctor may recommend a transurethral resection tur. All books are in clear copy here, and all files are secure so dont worry about it. Only two patients fulfilled the criterion for tur syndrome caused by. Transurethral resection syndrome occurred by bladder perforation during transurethral resection a case report. Plasmakinetic resection of the prostate has advantages. Transurethral resection of the prostate turp for benign. Endoscopic diagnosis and treatment in prostate pathology, 2016. This is best described as the transurethral resection of the prostate turp syndrome. Dec 03, 2009 transurethral resection of the prostate turp syndrome is a rare but potentially fatal syndrome with multifactorial pathophysiology that is now better understood. Pulmonary edema and cardiac arrest complicating transurethral. If your prostate becomes too large, your doctor may recommend a surgical procedure known as transurethral resection of the prostate turp. Approximately 40 000 transurethral resections of the prostate turp are performed annually in the uk. Complex shifts of water and electrolytes in the body. Anaesthesia for transurethral resection of the prostate bja.
The pathophysiology and management of this syndrome are controversial. Electrosurgical transurethral resection of the prostate. The majority of the transurethral resections were performed by surgical or urological trainees. Transurethral resection of the prostate commonly known as a turp, plural turps, and rarely as a transurethral prostatic resection, tupr is a urological operation. Electrosurgical transurethral resection of the prostate and.
The turp syndrome is an iatrogenic surgical complication but the responsibility for its diagnosis and treatment often falls upon the anaesthetist. Transurethral resection of the prostate turp syndrome is fluid overload and isoosmolar hyponatraemia during turp from large volumes of irrigation fluid being absorbed through venous sinuses. It occurs as a consequence of the absorption of the fluids used to irrigate the bladder during the operation into the prostatic venous sinuses. Benign prostatic hyperplasia bph is a common disease in aged men. Transurethral resection syndrome turs is a rare but serious complication of turp that has two different causes. Transurethral resection of the prostate turp syndrome. An instrument called a resectoscope is inserted through the tip of your penis and into the tube that carries urine from your bladder urethra. The turis system for transurethral resection of the prostate. We report a case of transurethral resection of prostate turp syndrome. Transurethral resection tur syndrome is an iatrogenic. Transurethral resection of the prostate turp syndrome is associated with. Read online transurethral resection of prostate turp book pdf free download link book now.
Pdf a transurethral resection of the prostate turp is often performed to treat benign prostatic. Transurethral resection of the prostate transyooreethruhl risekshuhn of the prosteyt. Transurethral resection of the prostate turp syndrome is defined by fluid overload during bladder irrigation, leading to hyponatremia and hypervolemia, and is a known complication of turp. Jun 11, 2019 download transurethral resection of the prostate euacme book pdf free download link or read online here in pdf. Transurethral enucleation with bipolar tueb allows for potentially blood free procedures and a gentle enucleation of the prostate. Download transurethral resection of prostate turp book pdf free download link or read online here in pdf. Complications associated with intraoperative use of irrigation fluid. How the puzzles of the transurethral resection of the. Reduced risk of transurethral resection syndrome through the use of saline irrigation fluid. Transient acute liver failure complicating the transurethral resection syndrome has been reported 61 a. Loss of antegrade ejaculation is a risk with conventional resection of the prostate transurethral resection of the prostate turp. Newer techniques of transurethral prostatic resection promise a reduced risk of.
Transurethral enucleation a bipolar alternative the tueb electrode enables the fast enucleation of larger prostates without having to invest in additional laser technology. Anaesthesia for transurethral resection of the prostate. Because liquid distending media are electrolyte free, serum sodium tends to equilibrate with intraperitoneal or retroperitoneal extravasate, leading in its net movement extravascularly. Ejaculationpreserving transurethral resection of prostate. Anesth, frca,2 andrew sinclair, frcs urol,1 and ian pearce, frcs urol1 abstract transurethral resection of the prostate turp syndrome is a rare but potentially fatal syndrome with multi. Between 1% and 8% of turp procedures are complicated by turp syndrome 1. Transurethral resection of the prostate turp involves the risk of transurethral resection tur syndrome owing to hyponatremia. Volumetric overload shocks in the pathoetiology of the. Newer techniques of transurethral prostatic resection promise a reduced risk of turp syndrome. Pindoria n 201 volumetric overload shocks in the pathoetiology of the transurethral resection prostatectomy syndrome and acute dilution hyponatraemia integr mol med, 2017 doi. This hypotonic, electrolytefree, nonconductive distension solution contains. Transurethral resection syndrome tur syndrome in contemporary series, the risk of tur syndrome after turp has decreased to free irrigating fluid, and consists of symptoms from the circulatory and nervous systems. Mild forms are common and often go undiagnosed, while severe forms of the tur syndrome are rare and.
Transurethral resection of the prostate turp syndrome is a rare but potentially fatal syndrome with multifactorial pathophysiology that is now better understood. The clinical picture is inconsistent and the syndrome is easily confused with other acute disorders. The syndrome has also been reported after endometrial ablation and ureteroscopic procedures with irrigating solutions. Turp syndrome current concepts in the pathophysiology and. Excessive intravascular or extravascular uptake of this fluid during turp is a classical complication transurethral resection reaction. The prostate is a walnutsized gland that is found only in men. After transurethral resection, a very small percentage of patients can develop transurethral resection syndrome turp syndrome. Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy. Feb 01, 2014 transurethral resection syndrome symptoms are cerebral edema and increased intracranial pressure, increased blood pressure, bradycardia, confusion, disorientation, muscle twitching, visual. Transurethral resection definition of transurethral.
A 54yearold man, without susceptibility factors for hepatitis, underwent transurethral resection of the prostate for benign prostatic hyperplasia followed by irrigation with glycine 1. The aim of this study was to determine the short and longterm preservation of antegrade ejaculation and functional results with the novel ejaculationpreserving turp epturp. There are multiple types of prostate surgeries, but the turp is one of the most common, and the one most closely associated with tur syndrome. Transurethral resection of the prostate turp mayo clinic.
In this study, we investigated the efficacy and safety of transurethral enucleation of prostate with button electrode. This surgical treatment removes prostate tissue to ease pressure on the urethra. Free water is absorbed into the brain parenchyma, causing water. Pdf transurethral resection of the prostate syndrome. A transurethral resection of prostate turp is done by removing the inner portion of the prostate that is pressing on the urethra. Medical treatment consisted of hypertonic saline solution 3% and. Pdf transurethral resection of the prostate turp syndrome is a. Turp syndrome, or tur syndrome, is an uncommon but serious complication of a specific type of prostate surgery.
In a retrospective study of 522 consecutive patients who were subjected to transurethral resection of the prostate with suprapubic trocar technique, six patients were suspected of having transurethral prostatic resection syndrome. The symptoms of tur syndrome include mental confusion, nausea, vomiting, high blood pressure, slowed. Aug 03, 2019 endoscopic treatment with transurethral resection of bladder tumor turbt is the firstline treatment to diagnose, stage, and treat visible tumors. Atypical presentation of acute hyponatremia in transurethral. Transurethral resection of the prostate turp syndrome is fluid overload and isoosmolar hyponatraemia during turp from large volumes of irrigation fluid being absorbed through venous sinuses irrigation fluid is required to maintain visibility despite bleeding tissue beds tupr syndrome can also occur in other procedures requiring.
1441 731 863 1132 278 624 657 87 380 839 1465 1197 250 393 668 657 1328 907 830 354 1106 1427 1105 378 825 468 1581 1598 6 1369 733 24 488 1463 884 194 898 1088 1233 475