Introduction: Transurethral resection of prostate (TURP) surgery is often done on men over the age of 40 who have benign prostatic hyperplasia (BPH). The fluid used to clean the area has 1.5% glycine in it. The potential complication of such procedure is systemic absorption of hypotonic irrigating fluid leading to fluid overload and resultant hyponatremia leading to manifestation of TUR syndrome. It should be treated promptly. Even though surgery and anaesthesia for TURP have improved a lot in recent years, 2.5–20% of patients who have TURP still, show one or more signs of TURP syndrome, and 0.5–5% die during surgery.
Objective : The objective of the study was to assess the extent of derangement of serum sodium levels following transurethral resection of prostate.
Methods: In this cross-sectional study, there were 40 participants, all of whom were men between the ages of 40 and 80 who met the criteria for participation. Patients who met the criteria were studied one after the other. A pre tested and validated proforma was used to collect data. The study subjects underwent routine preoperative anaesthesia checkup and optimisation prior to surgery. Preoperative S.Na+ and S.K+ were recorded. Standard monitors were attached and intravenous access was secured. Under strict asepsis after local infiltration with 2% lignocaine central neuraxial blockade was performed with 0.5% Bupivacaine (H) 2.2-2.5 mL. The level of the blockade was restricted to T10. Patients were placed in a lithotomy position and the surgery started using mono-polar cautery with 1.5% glycine irrigation fluid, keeping the irrigation fluid column at a height of 60 cm, from the patient. The resection time and irrigation time, the weight of the prostate gland resected, and the volume of 1.5% glycine used recorded during the procedure. The S.Na+ and S.K+ levels were done in patients at 1 hour and 3 hours after initiation of irrigation with 1.5 % glycine, using venous blood samples. Any value below 135 mEq/L was considered significant.
Results: The study showed that there is significant derangement of S.Na+ levels at 1Hr and 3Hr after initiation of irrigation with 1.5% glycine with a p value of 0.002 and 0.001 respectively.
Conclusion: Incidence of hyponatremia following TURP has not been decreased despite the advancement of management of BPH. The derangement of S.Na+ can become pronounced in the first three hours postoperatively.