Şiddetli bir TUR-P Sendromu olgusu
Şiddetli bir TUR-P Sendromu olgusu
Yazar: Tuzcu, Kasım; Canpolat, Halis; Sılay, Emin; Gökahmetoğlu, Günhan; İnci, Mehmet
Dergi: Cumhuriyet Tıp Dergisi, Vol. 36 No. 2, 2013
Anahtar kelimeler: TUR-P syndrome, Regional anesthesia, hyponatremia ; TUR-P sendromu, rejyonal anestezi, hiponatremi

ÖzetGünümüzde 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 AbstractAt 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

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.