TUR syndrome

TUR (hypervolemic-hypotonic) syndrome is a life-threatening complication of transurethral prostatectomy (TUPE, TURP). This condition is particularly serious in elderly people and cardiac patients, who experience an overload of the body's circulation with all possible consequences.

Etiopathogenesis[edit | edit source]

This condition occurs during extensive or long-lasting resection (over 60 minutes), when the irrigation solution is resorbed through the open periprostatic venous plexuses, thereby diluting the extracellular fluid.

A similar complication can rarely occur even after percutaneous lithotripsy of a stone in the kidney.

Symptoms[edit | edit source]

Unrest,
confusion,
shortness of breath
nausea ,
vomiting _
tachycardia ,
hypertension ,
hyperbilirubinemia ,
in the most severe cases, even anuria - from massive blockage of the glomeruli by fragments of disintegrated erythrocytes. Appears immediately after surgery.

Laboratory examination[edit | edit source]

This is dilutional hyponatremia.

Prevention[edit | edit source]

Prevention is the careful execution of TUR, consistent coagulation of large vessels and the use of low-pressure circulation of irrigation fluid.

Therapy[edit | edit source]

Administration of diuretics and hypertonic solution (10%) NaCl iv

Links[edit | edit source]

References[edit | edit source]

HANUŠ T. A KOL.:,. Vzdělávací program urologie UK 1LF- elektronický program [online]. [cit. 2015-01-19]. <https://el.lf1.cuni.cz/admin/content/folder/list?filter-rows=100&filter-start%0&sco-id=744722&tab-id=9>.

DVOŘÁČEK, Jan. Urologie praktického lékaře. 1. edition. Praha : ISV, 2000. 316 pp. pp. 65. ISBN 80-85866-52-8.