Role of preoperative assessment of serum sodium in transurethral resection of prostate to avoid transurethral resection of prostate syndrome: a comparative study

Authors

  • Bhavesh Gamit Department of General Surgery, GMERS Medical College, Gandhinagar, Gujarat, India
  • Nimesh Bharatkumar Thakkar Department of General Surgery, GMERS Medical College, Gandhinagar, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203246

Keywords:

BPH, Electrolyte imbalance, Endourology, Post-operative care, TURP syndrome

Abstract

Background: Transurethral resection of prostate syndrome (TURP) syndrome is an iatrogenic complication caused by absorption of the irrigating fluid which is used to distend the bladder during surgery.

Methods: A total of 100 patients with benign prostatic hyperplasia (BPH) were taken for study. Study was done in tertiary care centre in Gujarat from January 2016 to December 2017. They were evaluated pre-operative and post-operative for sodium concentration.

Results: In this study most of the patients i.e. 32 were seen in age group 61- 65 years.31% cases have developed hyponatremia out of 6% were having serum sodium level <125 mEq/l. 56% of cases were having prostate gland <40 cc. In 70% cases, TURP was completed within 60 minutes, while 30% cases required more than 60 minutes time. 13 were seen in age group 51 to 60 years, means 40.62% patients of this age group (13/32) and 12 patients were seen in age group 71-80 years, means 52.17% patients of this age group (12/23) were having post-operative hyponatremia. Out of 31 patients, 20 patients (64.52%) were having prostate size more than 60 cc and 11 patients (35.48%) were having prostate size between 46 to 60 cc.

Conclusions: From present study, it is concluded that electrolyte derangement occurs in older patients, with larger amount of tissue and longer time of resection and higher volume of irrigation fluid. It was also noticed that chances of electrolyte derangement are higher in patients with co-morbid conditions.

References

Mebust WK. Transurethral surgery. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED eds. Campbell's Urology. 6th edition. WB Saunders, Philadelphia; 1992:2900-2919.

Nesbit RM, Glickman SI. The use of glycine solution as an irrigating medium during transurethral resection. J Urol. 1948;59:12121-216.

Henderson DJ. Middleton RG. Coma from hyponatremia following transurethral resection of prostate. Urology. 1980;15:267-71.

Uchida T, Ohori M, Soh S, Sato T, Iwamura M, Ao T, Koshiba K. Factors influencing morbidity in patients undergoing transurethral resection of the prostate. Urology. 1999;53(1):98-104.

Aziz W, Ather MH. Frequency of electrolyte derangement after transurethral resection of prostate: Need for postoperative electrolyte monitoring. Adv Urol. 2015;2015.

Altaf J, Arain AH, Devrajani BR, Baloch S. Serum Electrolyte Disturbances in Benign Prostate Hyperplasia after Transurethral Resection of the Prostate. J Nephrol Ther. 2016:6;238.

Petrusheva AP, Kuzmanovska B, Mojsova M, Kartalov A, Spirovska T, Shosholcheva M, et al. Evaluation of changes in serum concentration of sodium in transurethral resection of the prostate. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2015;36(1):117-27.

Moorthy HK, Philip S. Serum electrolytes in TURP syndrome-Is the role of potassium under-estimated. Indian J Anaesth. 2002;46(6):441-5.

Gupta K, Rastogi B, Jain M, Gupta PK, Sharma D. Electrolyte changes: An indirect method to assess irrigation fluid absorption complications during transurethral resection of prostate: A prospective study. Saudi J Anaesth. 2010;4(3):142-6.

Chakithandy S, Evans R, Vyakarnam P. Acute severe hyponatraemia and seizures associated with postoperative enalapril administration. Anaesth Intens Care. 2009;37(4):673.

Singh M, Tassider GC, Blandy JP. The evaluation of transurethral resection for benign enlargement of the prostate. Br J Urol. 1973;45:93-102.

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Published

2020-07-23

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Original Research Articles