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1、90ContinuingMedicalEducationTheTURPsyndromeValerieJensenBscMDFRCPCThisarticlediscussesthepresentation,aetiology,treatmentContentsandpreventionofcentralnervoussystemdisturbancesafterPresentationtransurethralresectionoftheprostate.Nauseaandvomiting,-Altered
2、statesofconsciousnessvisualsymptoms,andalteredstatesofconsciousnesshavebeen-VisualdisturbancesreportedascomplicationsduetointravascularabsorptionofAetiologyirrigatingfluid.Hypotonicityafterabsorptionoftheirrigating-Irrigatingfluidfluidcausescerebraloedema
3、.Hyperglycinaemiamaycause-propertiesvisualdisturbancesandhyperammonaemiamaycausedelayed-absorptioncoma.-Effectsofabsorption-sodiumCetarticlediscutedelapresentation,raetiologie,letraitement-osmolalityetlapreventiondesprobldmesdusystt~menerveuxcentralaprds-
4、tonicityRTUP.Lesnausdes,lesvomissements,les,~ympt6mesvisuels,-colloidosmoticpressurel'alterationdelaconscienceontdtErapportEscommecomplica--potassiumtionsdt'lt~uneabsorptionintra-vasculaireduliquided'irriga--Glycinetion.L'hypotonicitdaprdsabsorptionduliqu
5、ided'irrigation-highconcentrationsofglycineprovoquel'cedEmecdrEbral.L'hyperglycindmiepeutcauserdes-metabolismperturbationsdelavisionetl'hyperammonidmiepeutprovoquer-ammoniauncomaretardS.Treatment-Themildlysymptomaticpatient-Theunconsciouspatient-Hypertoni
6、csaline-NeurologicalcomplicationsPreventionReferencesSelf-assessmentquestionsCentralnervoussystem(CNS)complicationsafterintra-vascularabsorptionofirrigatingfluidduringtransurethralresectionoftheprostate(TURP)rangeinseverityfromminortolife-threateningandde
7、pendontherateandamountofabsorption.Glycine,1.5percent,isthemostcommonlyusedirrigatingfluid.BecauseglycineisaKeywordspermeantsolute,intracellularoedemamayoccuruponCOMPLICATIONS:TURPsyndrome;absorption.Toxiceffectsmayoccurfromhighconcentra-SURGERY:urologica
8、l;tionsofammonia,whichisaby-productofthemeta-IONS:sodium.bolismofglycine,andfromhighconcentrationsofDepartmentofAnaesthesia,WMC3B2.32,Universityofglycineitself.AcuteseverehypotonicityleadingtoAlbertaHospitals,8440-1
