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Abstract
RÉSUMÉ
The TURP syndrome " Transurethral resection of the prostate " is a complication defined by fluid overload during bladder irrigation to the Transurethral resection of the prostate. We report the case of a 70-year-old patient, who had a transurethral resection of the prostate under spinal anesthesia for benign prostate hypertrophy. In the immediate aftermath of the operation, the patient suddenly presented confusion, nausea and vomiting. Visual blurring and transient bilateral blindness was also reported. Brain MRI did not reveal any diffusion signal abnormalities. The ophthalmological examination revealed bilateral papilledema and the biological workup showed severe hyponatremia at 115mmol /l. The evocative context and the paraclinical data made it possible to retain the diagnosis of TURP syndrome. The management consisted in the correction of hyponatremia. The evolution after 4 days was marked by an improvement of the neurological signs. TURP syndrome is a complication that should be considered during or after urological surgery with fluid irrigation even when the sudden appearance of neurological signs leads to the suspicion of a vascular event.
ABSTRACT
Le TURP syndrome « Transurethral resection of the prostate » est une complication liée à l’absorption massive de liquide d’irrigation et qui survient après une résection transuréthrale de la prostate. Nous rapportons le cas d’un patient de 70 ans, qui a bénéficié d’une résection transuréthrale de la prostate. Dans les suites opératoires, le patient a présenté de façon brutale une confusion accompagnée de nausées et de vomissements. Un flou visuel suivi d’une cécité bilatérale transitoire a également été rapporté. L’examen ophtalmologique rapportait un œdème papillaire bilatéral et le bilan biologique retrouvait une hyponatrémie sévère à 115 mmol /l. Le contexte évocateur a permis de retenir le diagnostic de TURP syndrome. Le TURP syndrome est une complication qu’il faut savoir évoquer même lorsque l’apparition brutale des signes neurologiques fait suspecter un événement vasculaire.
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References
- Al-Hajjaj M, Kanjo M, Tallaa M. TURP syndrome: A rare case report from Syria. Int J Surg Case Rep 2022;93:107021. https://doi.org/10.1016/j.ijscr.2022.107021.
- Kumar V, Vineet K, Deb A. TUR syndrome - A report. Urol Case Rep 2019;26:100982. https://doi.org/10.1016/j.eucr.2019.100982.
- Vijayan S. TURP syndrome. Trends Anaesth Crit Care 2011;1:46–50. https://doi.org/10.1016/j.cacc.2010.07.002.
- Chraa M, Kissani N. Facteurs de risque des accidents vasculaires cérébraux. Rev Neurol (Paris) 2015;171:A35. https://doi.org/10.1016/j.neurol.2015.01.074.
- Gravenstein D. Transurethral resection of the prostate (TURP) syndrome: a review of the pathophysiology and management. Anesth Analg 1997;84:438–46.
- Moorthy HK, Philip S. TURP syndrome-current concepts in the pathophysiology and management. Indian J Urol 2001;17:97.
- Issa MM, Young MR, Bullock AR, Bouet R, Petros JA. Dilutional hyponatremia of TURP syndrome: a historical event in the 21st century. Urology 2004;64:298–301.
- Hahn RG. Fluid and electrolyte dynamics during development of the TURP syndrome. Br J Urol 1990;66:79–84.
- Nghe M-C. Complications oculaires en chirurgie non ophtalmologique. Prat En Anesth Réanimation 2018;22:195–202. https://doi.org/10.1016/j.pratan.2018.06.008.
- Petrusheva AP, Kuzmanovska B, Mojsova M, Kartalov A, Spirovska T, Shosholcheva M, et al. Evaluation of changes in serum concentration of sodium in a transurethral resection of the prostate. Prilozi 2015;2015:0036.
- Benlamkaddem S, Houari N, Boukatta B, Sbai H, Kanjaa N. TURP syndrome: à propos d’un cas. Pan Afr Med J 2017;28.
References
Al-Hajjaj M, Kanjo M, Tallaa M. TURP syndrome: A rare case report from Syria. Int J Surg Case Rep 2022;93:107021. https://doi.org/10.1016/j.ijscr.2022.107021.
Kumar V, Vineet K, Deb A. TUR syndrome - A report. Urol Case Rep 2019;26:100982. https://doi.org/10.1016/j.eucr.2019.100982.
Vijayan S. TURP syndrome. Trends Anaesth Crit Care 2011;1:46–50. https://doi.org/10.1016/j.cacc.2010.07.002.
Chraa M, Kissani N. Facteurs de risque des accidents vasculaires cérébraux. Rev Neurol (Paris) 2015;171:A35. https://doi.org/10.1016/j.neurol.2015.01.074.
Gravenstein D. Transurethral resection of the prostate (TURP) syndrome: a review of the pathophysiology and management. Anesth Analg 1997;84:438–46.
Moorthy HK, Philip S. TURP syndrome-current concepts in the pathophysiology and management. Indian J Urol 2001;17:97.
Issa MM, Young MR, Bullock AR, Bouet R, Petros JA. Dilutional hyponatremia of TURP syndrome: a historical event in the 21st century. Urology 2004;64:298–301.
Hahn RG. Fluid and electrolyte dynamics during development of the TURP syndrome. Br J Urol 1990;66:79–84.
Nghe M-C. Complications oculaires en chirurgie non ophtalmologique. Prat En Anesth Réanimation 2018;22:195–202. https://doi.org/10.1016/j.pratan.2018.06.008.
Petrusheva AP, Kuzmanovska B, Mojsova M, Kartalov A, Spirovska T, Shosholcheva M, et al. Evaluation of changes in serum concentration of sodium in a transurethral resection of the prostate. Prilozi 2015;2015:0036.
Benlamkaddem S, Houari N, Boukatta B, Sbai H, Kanjaa N. TURP syndrome: à propos d’un cas. Pan Afr Med J 2017;28.