TURP syndrome is a rare and life-threatening complication of transurethral resection of the prostate surgery.

It is caused by irrigation with large volumes of glycine, which is hypo-osmolar and is systemically absorbed when prostatic venous sinuses are opened up during prostate resection. This results in hyponatremia, and when glycine is broken down by the liver into ammonia, hyper-ammonia and visual disturbances.

TURP syndrome typically presents with CNS, respiratory and systemic symptoms

The risk factors for developing TURP syndrome are :

• surgical time > 1 hr
• height of bag > 70cm
• resected > 60g
• large blood loss
• perforation
• large amount of fluid used
• poorly controlled CHF