Incidence – Historically, TURP syndrome occurred in 2-15% of patients. Now incidence is lower at around 1.1% with newer surgical techniques.
Mechanism – Continuous irrigation is readily absorbed by prostatic tissue due to large venous sinuses. Generally speaking, 10 to 30 cc of solution is absorbed per minute of resection time. The amount absorbed depends on duration of procedure, hydrostatic pressure and magnitude of surgical venous sinuses opening. If monopolar cautery used, LR and normal saline can’t be used and water was often used leading to hyponatremia and volume overload. This is more problematic in patients with reduced myocardial function.
CNS Symptoms
- Early signs: nausea, headache, and dizziness
- Agitation/confusion with bradycardia and elevated BP
- Seizures
- Coma
- Visual disturbances including blindness
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