Fluid and electrolyte dynamics during development of the TURP syndrome

Signs and symptoms, circulatory changes and the diffusion of fluid and electrolytes were examined over 10-min periods in the course of 12 transurethral resections of the prostate (TURP) during which more than 1 litre of glycine solution was absorbed. Signs of the TURP syndrome were seen in 10 patients. During the first 20 min of absorption there was hypervolaemia, a marked diffusion of electrolytes from the interstitial space to the plasma, and elevation of central venous pressure. Patients who developed hypertension (n = 6) and chest pains (n = 3) had a smaller blood loss than those who did not. After 20 min of irrigant absorption there was an increased flow of fluid from the plasma to the interstitial space coupled with only a small diffusion of sodium. This promoted hypovolaemia and hypotension.