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Transurethral resection syndrome after transurethral resection of bladder tumours

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Abstract

The transurethral resection syndrome has not previously been described after bladder surgery. This article reports four patients who developed signs of this syndrome after transurethral resection of bladder tumours (TURB). Symptoms included abdominal pain, arterial hypotension, nausea and vomiting. There was evidence in all cases that the cause was absorption of irrigating fluid by the extravascular route. Fluid absorption was detected by ethanol in two patients and the urologist noted a perforation during the third operation. The most complicated clinical course occurred in the case where there was a delay of three hours before the diagnosis was made. Medical treatment consisted of antiemetics and volume expansion of the extracellular fluid compartment as extravasation is associated with hypovolaemia. Diuretics were not given until the circulation had been restored.

Résumé

Jusqu’à maintenant, on n’a pas décrit le syndrome de la résection transuréthrale après une intervention sur la vessie. Cet article rapporte quatre observations de patients qui ont développé les signes du syndrome après une résection transuréthrale de tumeurs vésicates (RTUV). Les symptômes comprenaient de la douleur abdominale, de l’hypertension artérielle, des nausées et vomissements. Dans tous ces cas, il paraissait évident que le syndrome était causé par la réabsorption extravasculaire du liquide d’irrigation. Dans deux interventions, l’absorption de liquide a été décelée grâce à l’éthanol alors que c’est l’urologue qui a noté une perforation vésicale dans une troisième intervention. L’évolution clinique s’est compliquée avec la lenteur à du diagnostic. Le traitement a consisté à l’administration d’un anti-émétique et, comme l’extravasation s’accompagne d’hypovolémie, au remplissage vasculaire. Les diurétiques n’ont été administrés qu’après la restauration de la circulation.

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Correspondence to Robert G. Hahn.

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Hahn, R.G. Transurethral resection syndrome after transurethral resection of bladder tumours. Can J Anaesth 42, 69–72 (1995). https://doi.org/10.1007/BF03010574

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Key words

  • alcohol: absorption, exhaled
  • complications
  • surgery: urological
  • Syndromes
  • Tur