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[Transurethral resection using glycine irrigation].

R Vila, M Salvadores, R Puig

Annales Francaises D'Anesthesie Et De Reanimation

|January 1, 1987

Summary

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A transurethral resection complication occurred due to glycine irrigation, causing hyponatremia and seizures. Prompt treatment led to full recovery, highlighting regional anesthesia

Area of Science:

Urology
Anesthesiology
Nephrology

Background:

Transurethral resection of the prostate (TURP) is a common procedure.
Glycine solutions are frequently used for irrigation during TURP.
Potential complications include TURP syndrome, characterized by fluid overload and electrolyte imbalances.

Observation:

A 68-year-old patient undergoing TURP experienced visual disturbances, mydriasis, and drowsiness after 14L of 1.5% glycine irrigation.
No hemodynamic instability was noted during the procedure.
Seizures developed three hours post-surgery with a serum sodium level of 118 mmol/L.

Findings:

The patient's symptoms were attributed to symptomatic hyponatremia, a component of TURP syndrome.
The low sodium level correlated with the significant fluid absorption during the prolonged surgery.

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Symptomatic treatment effectively managed the hyponatremia and associated neurological deficits.

Implications:

This case underscores the risk of TURP syndrome even with regional anesthesia, which may mask early signs.
Early recognition and management of hyponatremia are crucial for preventing severe neurological complications.
Careful monitoring of irrigation fluid volume and patient's neurological status is essential during lengthy TURP procedures.