Hyponatraemia after transurethral resection of the prostate

Transurethral resection (TUR) syndrome is a complication of transurethral resection of the prostate characterized by bradycardia, hypotension and postoperative confusional state, which is generally attributed to hyponatraemia occurring during or immediately after operation. In a prospective study of 100 consecutive patients undergoing transurethral resection of the prostate, changes in serum sodium were estimated before and after operation and correlated with various parameters including weight of prostate resected, volume of irrigant fluid and resection time. Seven patients showed a significant drop (greater than 10 mmol/litre) in serum sodium: two of these had the clinical features of TUR syndrome and one of them died. The pathogenesis and management of this syndrome are discussed.