The pathophysiology of<unk>  is complex and does not always follow the same sequence of events, which explains why the set of signs and symptoms are variable and non-specific. The type of irrigation fluid used will also have a bearing on the pathophysiological events: normal saline or Hartmann’s fluid do not cause harm when absorbed into the circulation, however they may dissipate current from the resectoscope and cause injury to the patient. Commonly used fluids for TURP procedures include glycine, sterile water and glucose solution. Fluid overload Absorption of small volumes of irrigating fluid via the<unk> c venous sinuses will inevitably occur in most TURP operations. The average rate of absorption is 20ml/min, and therefore length of surgery may have an effect on the total volume absorbed. Fluid absorption leads to rapid volume expansion, which causes hypertension and reflex bradycardia. The oncotic pressure of blood will decrease as a result of the dilution of serum proteins, and this coupled with hypertension will push fluid from the intra-vascular to the interstitial compartment causing pulmonary and cerebral edema. Patients with impaired left ventricular function may furthermore develop pulmonary edema as a result of the acute circulatory overload. Hyponatraemia The excessive absorption of fluid will rapidly dilute the serum sodium concentration. This fall in sodium concentration will create an osmotic gradient between intra- and extra- fluid within the brain, leading to net fluid shift away from intra-vascular compartment resulting in cerebral oedema and raised intra-cranial pressure. The symptoms resulting from hyponatraemia will depend on both the severity of the drop as well as the speed at which the concentration decreased. Sodium concentration below 120mMol/L defines severe<unk> . The normal range of sodium is 135-145mMol/L Hyperammonaemia Glycine, a commonly used fluid for irrigation, gains entry to the intra-vascular compartment via the<unk> c venous sinuses, and is then metabolized in the portal bed and kidneys. Ammonia is a major by-product of glycine metabolism. Encephalopathy may ensue if ammonia serum concentration rise sufficiently. Hypothermia Bladder irrigation is a significant source of heat loss. Body core temperature may fall if the irrigating fluids used are instilled at room temperature for a prolonged period of time during the operation.
Transurethral resection of the prostate syndrome
Overactive bladder
Underactive bladder
Chronic bacterial prostatitis
Benign prostatic hyperplasia
Urethral cancer
Urethral syndrome
Urinary bladder disease