[An adverse effect of glycine irrigation solution: absorption syndrome]

Endoscopic operations in the genitourinary tract require the use of an irrigating fluid containing glycine 1.5% and expose patients to adverse events in relation with the absorption of that irrigating fluid, summarized as "transurethral resection reactions" (TURP syndrome). Intra and extra vascular absorption are now well described. The uptake of 1000 ml of fluid corresponds to an acute decrease in the serum sodium concentration of 5-8 mmol.l-1 and give poor clinical signs. This is the volume above which the risk of absorption-related symptoms is statistically increased. Dilutional hyponatraemia and toxicity of glycine and/or its metabolites explain the clinical symptoms. Hyponatraemia and the osmotic gap assess the diagnosis of TUR syndrome. There is a threat to life and a knowledge of an adequate management is essential. Ethanol monitoring is an non invasive method to prevent and detect early irrigating fluid absorption.