Transurethral Resection Syndrome Detected and Managed Using Transesophageal Doppler

Abstract

In Brief Transurethral resection syndrome during transurethral resection of the prostate (TURP) results from excessive absorption of electrolyte-free irrigation fluids causing acute hypervolemia and hyponatremia. Neuraxial anesthesia is often recommended for TURP procedures because early signs of neurological deterioration can be detected. However, in patients requiring general anesthesia, other continuous and noninvasive measures are needed. Acute intravascular hypervolemia should be reflected by changes in hemodynamic values. Transesophageal Doppler ultrasonography of the aorta allows determination of stroke volume and other advanced hemodynamic variables related to intravascular volume status. We describe the first case of intraoperative detection of a TURP syndrome by noninvasive Doppler monitoring of hemodynamic variables during TURP. IMPLICATIONS: Transurethral resection of the prostate syndrome results from excessive absorption of irrigation fluids. A case of transurethral resection of the prostate syndrome is presented, demonstrating that transesophageal Doppler monitoring may allow early detection of acute hypervolemia and facilitate subsequent management.