What Is TURP Syndrome?

TURP Syndrome, or TUR syndrome, is an uncommon but serious complication of a specific type of prostate surgery. There are multiple types of prostate surgeries, but the transurethral resection of prostate surgery (TURP), is one of the most common and the one most closely associated with TUR syndrome.

TURP syndrome has decreased in occurrence significantly with advancements in how the procedure is performed. 

During the procedure, a constant stream of sterile irrigation solution is used to allow the surgeon to see the prostate during the procedure. The problem arose from the type of fluid used during the irrigation which in the past used to be similar to water.

When this solution is low in sodium, and the body absorbs too much of the fluid, the sodium level in the entire body can fall rapidly. Low sodium concentration in the body leads to hyponatremia, a condition that can be quite serious, and even life-threatening in severe cases.

Today most of these procedures are done using sterile saline which has sodium in the fluid already. This better balanced irrigation system decreases the absorption by the body and then the risks of TUR syndrome.

Other Causes of TUR Syndrome

Hyponatremia, which is low blood sodium, can occur due to many different medical conditions. TUR syndrome refers to hyponatremia caused by flushing during a surgical procedure.

While this syndrome is most common in patients having a TURP, it has been known to happen during other procedures that involve the same type of constant flushing with fluids.

How Serious Is TUR Syndrome?

Most cases of TUR syndrome are mild to moderate in severity and can be treated without any consequences. But severe cases are life-threatening. 

According to one study, the mortality rate for patients with severe TUR syndrome has been noted to be as high as 25%. Fortunately, studies that look at recent TURP procedures indicate that less than 2 patients in a thousand develop this type of serious complication after their TURP surgery.

Signs and Symptoms of TUR Syndrome

A low level of sodium in the body can cause fatigue, nausea, vomiting, disorientation, and in severe cases, brain edema and seizures. It may also cause a slow heart rate and low blood pressure. In the most severe cases, loss of consciousness or coma can occur.

Treatment varies based on sodium level, which can be determined by a simple blood test. Treatment may be as simple as restricting fluid intake or may involve IV medication or the administration of salt.

Generally, correction of hyponatremia is done slowly and gradually, rather than rapidly. Rapid shifts in the body's sodium and fluid concentrations can also be dangerous. That said, hyponatremia correction may require an ICU admission.

Also Known As: hyponatremia, low sodium, low blood sodium, Transurethral resection syndrome, transurethral resection of the prostate syndrome, water intoxication

Alternate Spellings: TUR syndrome, TURP Syndrome

Examples: After having a transurethral resection of the prostate, the man appeared disoriented and began vomiting. His doctor determined that he was experiencing TURP syndrome.

Frequently Asked Questions

How long after surgery can TUR syndrome occur?

It can occur just a few minutes after surgery begins or several hours after surgery is completed.

How is TUR syndrome treated?

Treatment may include fluid restriction, administration of hypertonic saline (high in sodium), and/or nebulized levosalbutamol.