Öz
At the present time despite the development of new treatment modalities like laser usage; traditional transurethral prostate resection is the gold standard in benign prostatic hypertrophy. However, TUR-P syndrome may develop in 1.1% of these cases. In our patient who was 66years old and 82 kg weight, although the hemodynamics was normal intraoperatively under spinal anesthesia, respiratory difficulty, hypotension and convulsion were developed after headache and nausea. In auscultation there were crepitant rales and there were bilateral interstitial infiltrations on chest radiography. In laboratory tests hyponatremia and thrombocytopenia were detected, the patient was diagnosed as TUR-P and the treatment was commenced. In conclusion, regional anesthesia allows the evaluation of mental status of the patients and provides early diagnosis and treatment of TUR-P syndrome. However, we suggest that the anesthesia doctor should have experience and attention in recognizing this syndrome.
Anahtar Kelimeler
Kaynakça
- Resim S, Bulut BB. Benign prostat hiperplazisi tedavisinde transüretral prostat rezeksiyonu hâlâ altin standart mi? Türkiye Klinikleri J Urology-Special Topics 2013; 6: 63-70.
- Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)-incidence, management, and prevention. European Urology 2006; 50: 969-79.
- Creevy CD. Hemolytic reactions during transurethral prostatic resection. Journal of Urology 1947; 58: 125-31.
- Hahn RG. The transurethral resection syndrome. Acta Anaesthesiol Scand 1991; 35: 557-67.
- Gray RA, Lynch C, Hehir M, Worsley M. Intravesical pressure and the TUR syndrome. Anaesthesia 2001; 56: 461-5.
- Özmen S, Koşar A, Soyupek S, Armağan A, Hoşcan MB, Aydın C. The selection of the regional anaesthesia in the transurethral resection of the prostate (TURP) operation. International Urology and Nephrology 2003; 35: 507-12. Gehring H, Nahm W, Baerwald WJ, Fornara P, Schneeweiss A, Roth-Isigkeit A, Schmucker P. Irrigation fluid absorption during transurethral resection of the prostate: spinal vs. general anaesthesia. Acta Anesthesiol Scand 1999; 43: 4586
- Özkan D, Ergil J, Özmen M, Mendeş F, Gümüş H. Spinal anestezi altında gelişen transüretral prostat rezeksiyonu (TUR-P) sendromu. Anestezi Dergisi 2010; 18: 235Monk TG, Weldon BC. The renal system and anesthesia for urologic surgery. In: Barash PG, Cullen BF, Stoelting RK, editors. Clinical Anesthesia. Fourth edition. Philadelphia: Lippincott Williams & Wilkins 2000; 1005-33.
- Sert Ü, Kılıç Ö. BPH’da endoskopik cerrahi tedavi. Üroonkoloji Bülteni 2011; 10: 30-3.
Öz
Özet
Günümüzde benign prostat hipertrofisinde (BPH), lazer kullanımı gibi alternatif cerrahi tedaviler geliştirilmesine rağmen klasik transüretral prostat rezeksiyonu (TUR-P) yöntemi hala altın standart olarak görülmektedir. Ancak bu yöntemin uygulandığı olguların %1,1’inde TUR-P sendromu gelişebilmektedir. Spinal anestezi altında 66 yaşında, 82 kg ağırlığındaki olgumuzda intraoperatif dönemde hemodinami stabil seyrederken baş ağrısı ve bulantı şikayetinin ardından görme bozukluğu, solunum sıkıntısı, hipotansiyon ve konvülzyon gelişti. Her iki akciğerde dinlemeyle bilateral krepitan ralleri olan hastanın çekilen akciğer grafisinde bilateral interstisyel infiltrasyonlar tespit edildi. Yapılan tetkiklerde hiponatremi ve trombositopeni tespit edilen hastaya TUR-P sendromu tanısı konularak tedavisi düzenlendi. Sonuç olarak rejyonal anestezi hastanın mental durumunun değerlendirilmesini sağlayarak TUR-P sendromunun erken tanı ve tedavisine olanak sağlar. Ancak anestezi doktorunun bu sendromu tanımada deneyimli ve dikkatli olması gerektiğini düşünüyoruz.
Anahtar sözcükler: TUR-P sendromu, rejyonal anestezi, hiponatremi
Abstract
At the present time despite the development of new treatment modalities like laser usage; traditional transurethral prostate resection is the gold standard in benign prostatic hypertrophy. However, TUR-P syndrome may develop in 1.1% of these cases. In our patient who was 66years old and 82 kg weight, although the hemodynamics was normal intraoperatively under spinal anesthesia, respiratory difficulty, hypotension and convulsion were developed after headache and nausea. In auscultation there were crepitant rales and there were bilateral interstitial infiltrations on chest radiography. In laboratory tests hyponatremia and thrombocytopenia were detected, the patient was diagnosed as TUR-P and the treatment was commenced. In conclusion, regional anesthesia allows the evaluation of mental status of the patients and provides early diagnosis and treatment of TUR-P syndrome. However, we suggest that the anesthesia doctor should have experience and attention in recognizing this syndrome.
Keywords: TUR-P syndrome, Regional anesthesia, hyponatremia
Anahtar Kelimeler
Kaynakça
- Resim S, Bulut BB. Benign prostat hiperplazisi tedavisinde transüretral prostat rezeksiyonu hâlâ altin standart mi? Türkiye Klinikleri J Urology-Special Topics 2013; 6: 63-70.
- Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)-incidence, management, and prevention. European Urology 2006; 50: 969-79.
- Creevy CD. Hemolytic reactions during transurethral prostatic resection. Journal of Urology 1947; 58: 125-31.
- Hahn RG. The transurethral resection syndrome. Acta Anaesthesiol Scand 1991; 35: 557-67.
- Gray RA, Lynch C, Hehir M, Worsley M. Intravesical pressure and the TUR syndrome. Anaesthesia 2001; 56: 461-5.
- Özmen S, Koşar A, Soyupek S, Armağan A, Hoşcan MB, Aydın C. The selection of the regional anaesthesia in the transurethral resection of the prostate (TURP) operation. International Urology and Nephrology 2003; 35: 507-12. Gehring H, Nahm W, Baerwald WJ, Fornara P, Schneeweiss A, Roth-Isigkeit A, Schmucker P. Irrigation fluid absorption during transurethral resection of the prostate: spinal vs. general anaesthesia. Acta Anesthesiol Scand 1999; 43: 4586
- Özkan D, Ergil J, Özmen M, Mendeş F, Gümüş H. Spinal anestezi altında gelişen transüretral prostat rezeksiyonu (TUR-P) sendromu. Anestezi Dergisi 2010; 18: 235Monk TG, Weldon BC. The renal system and anesthesia for urologic surgery. In: Barash PG, Cullen BF, Stoelting RK, editors. Clinical Anesthesia. Fourth edition. Philadelphia: Lippincott Williams & Wilkins 2000; 1005-33.
- Sert Ü, Kılıç Ö. BPH’da endoskopik cerrahi tedavi. Üroonkoloji Bülteni 2011; 10: 30-3.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Haziran 2014 |
| Yayımlandığı Sayı | Yıl 2014Cilt: 36 Sayı: 2 |