Ekstremno brz razvoj sindroma transuretralne resekcije prostate.

Background. The transurethral resection of the prostate (TURP) syndrome is reported after ureteroscopic procedures with irrigating solutions. TURP syndrome may occur quickly or up to 24 hours postoperatively. TURP syndrome affects many systems and manifests itself mainly through acute changes in intravascular volume and plasma solute concentrations. Case report. We reported a 72-year-old patient with benign prostatic hyperplasia, diabetes mellitus and angina pectoris who underwent TURP under spinal anesthesia. Unusual marked somnolence, bradycardia (38 beats/min), disorientation and face edema indicated a diagnosis of TURP syndrome only 15 minutes after the operation had started. The diagnosis confirmed by arterial gas analyses (metabolic acidosis, pH was 7.29) and hyponatremia (96 mmol/l). Agressive and adequate therapy with diuretic and bicarbonates decreased symptoms and saved patient's life. Conclusion. Very fast development of TURP syndrome is possible. Continuous patient monitoring is necessary to provide fast recognition of TURP syndrome. Adequate therapy can prevent considerable complications. [ABSTRACT FROM AUTHOR]

Uvod. Sindrom transuretralne resekcije prostate (TURP) javlja se posle ure tro skopskih procedura kod kojih se koristi tečnost za irigaciju. Sindrom TURP može se javiti veoma brzo, ali i u prva 24 časa posle operacije. Sindrom TURP utiče na mnoge sisteme i dovodi do promena u intravaskularnom volumenu i osmolalnosti plazme. Prikaz bolesnika. Prikazan je 72-godišnji bolesnik sa benignom hiperplazijom prostate, šećernom bolešću i anginom pektoris, koji je podvrgnut TURP u spinalnoj anesteziji. Neobično izražena somnolencija, bradikardija (38 otkucaja/min), dezorijentacija i edem lica ukazali su na dijagnozu sindroma TURP samo 15 minuta nakon početka operacije. Dijagnoza je potvrđena pomoću gasnih analiza arterijske krvi (metabolička acidoza, pH arterijske krvi 7,29) i hiponatrijemije (96 mmol/l). Agresivna i adekvatna terapija diureticima i bikarbonatima smanjila je simptomatologiju i sačuvala život bolesniku. Zaključak. Veoma brz razvoj sindroma TURP je moguć. Stalan nadzor bolesnika je neophodan, jer omogućava pravovremeno prepoznavanje TURP sindroma. Primena adekvatne terapije sprečava razvoj značajnih komplikacija. [ABSTRACT FROM AUTHOR]