TURP Syndrome

What Is TUR Syndrome?

Nurse passing forceps to doctor in operating room
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TUR Syndrome Explained

TURP Syndrome, or TUR syndrome, is an uncommon but serious complication of a specific type of prostate surgery.  There are multiple types of prostate surgeries, but the the TURP is one of the most common, and the one most closely associated with TUR syndrome. 

During Trans Urethral Resection of the Prostate surgery (TURP), a sterile irrigation solution that is similar to water is used to keep the surgical area clean.

 This sterile fluid is also used to prevent distribution of cancer cells, if they are present, by constantly washing out the surgical site. This constant rinsing of the surgical area is thought to prevent the spread of cancer by washing any cancer cells dislodged by the procedure out of the body with the fluid.  

Large quantities of this sterile solution are used to perform the constant flushing during the procedure. If this solution is low in sodium, and the body absorbs too much of the fluid, the sodium level in the entire body can fall rapidly. This condition is called hyponatremia and can be quite serious, and even life-threatening in severe cases.

Other Causes of TUR Syndrome

​While this syndrome is most common in patients having a transurethral resection of the prostate, it has been known to happen during other procedures that require the same type of constant flushing with fluids that is done during the TURP.

How Serious is TUR Syndrome?

Most cases of TUR syndrome are mild to moderate in severity, but severe cases are life-threatening.  According to one study, the mortality rate for patients with severe TUR syndrome is as high as 25%. Fortunately, studies that look at recent TURP procedures indicate that less than 2 patients in a thousand develop this type of serious complication after their TURP surgery.

Signs and Symptoms of TUR Syndrome

Hyponatremia, which is low blood sodium, that is caused by the constant flushing during surgery. This low level of sodium in the body can cause disorientation, nausea, vomiting, fatigue, and in severe cases, brain edema and seizures.  One early sign, which is very specific to the condition, is a prickling/burning sensation in the face and neck often accompanied by feelings of fear and feeling tired.   The patient may also experience a slow heart rate and low blood pressure.   In the most severe cases, seizures, coma or loss of consciousness can occur along with the more mild symptoms. 

Treatment varies based upon the severity of the low sodium, which can be determined by a simple blood test. Treatment may be as simple as restricting fluid intake, or may involve IV medication, or the administration of salt.

Also Known As: hyponatremia, low sodium, low blood sodium, Transurethral resection syndrome, transurethral resection of the prostate syndrome, water intoxication

Alternate Spellings: TUR syndrome, TURP Syndrome

Examples: After having a transurethral resection of the prostate, the man appeared disoriented and began vomiting. His doctor determined that he was experiencing TURP syndrome.

Source:

Transurethral resection of the prostate syndrome: Almost gone but not forgotten.  Journal of Endourology.  Accessed November, 2015. http://online.liebertpub.com/doi/pdf/10.1089/end.2009.0129

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