What is TURP syndrome and what causes it?

• A. Hypertension due to bladder spasms
• B. Hyponatremia due to absorption of irrigation fluid during TURP
• C. Hyperkalemia due to tissue injury
• D. Hypocalcemia due to citrate

Answer: (B)

TURP syndrome happens when the irrigation fluid used during transurethral resection of the prostate is absorbed into the bloodstream. As tissue is resected, the prostatic venous channels can take up the irrigation solution, and if that fluid is hypotonic (for example glycine or sterile water-based solutions), its absorption dilutes the blood sodium concentration. This creates hyponatremia and lowered serum osmolality, which can trigger neurologic symptoms such as confusion or seizures and cardiovascular instability from fluid overload. So the best answer points to hyponatremia caused by absorption of irrigation fluid during TURP. The other options describe different issues that aren’t the defining mechanism of TURP syndrome.