What Is TURP Syndrome?

TURP Syndrome, or TUR syndrome, is an uncommon but serious complication of a specific type of prostate surgery. There are multiple types of prostate surgeries, but the transurethral resection of prostate surgery (TURP), is one of the most common and the one most closely associated with TUR syndrome.

During this procedure, a sterile irrigation solution that is similar to water is used to keep the surgical area clean. This sterile fluid is also used to prevent the distribution of cancer cells, if they are present, by constantly washing out the surgical site. This constant rinsing of the surgical area is thought to prevent the spread of cancer by washing any cancer cells dislodged by the procedure out of the body with the fluid.

Large quantities of this sterile solution are used to perform the constant flushing during the procedure. If this solution is low in sodium, and the body absorbs too much of the fluid, the sodium level in the entire body can fall rapidly. Low sodium concentration in the body leads to hyponatremia, a condition that can be quite serious, and even life-threatening in severe cases.

Nurse passing forceps to doctor in operating room
Michael H / Digital Vision / Getty Images 

Other Causes of TUR Syndrome

Hyponatremia, which is low blood sodium, can occur due to many different medical conditions. TUR syndrome refers to hyponatremia caused by flushing during a surgical procedure.

While this syndrome is most common in patients having a TURP, it has been known to happen during other procedures that involve the same type of constant flushing with fluids.

How Serious Is TUR Syndrome?

Most cases of TUR syndrome are mild to moderate in severity and can be treated without any consequences. But severe cases are life-threatening. 

According to one study, the mortality rate for patients with severe TUR syndrome has been noted to be as high as 25%. Fortunately, studies that look at recent TURP procedures indicate that less than 2 patients in a thousand develop this type of serious complication after their TURP surgery.

Signs and Symptoms of TUR Syndrome

A low level of sodium in the body can cause fatigue, nausea, vomiting, disorientation, and in severe cases, brain edema and seizures. It may also cause a slow heart rate and low blood pressure. In the most severe cases, loss of consciousness or coma can occur.

One early sign, which is very specific to the condition, is a prickling/burning sensation in the face and neck that can be accompanied by feelings of fear and feeling tired. 

Treatment varies based on sodium level, which can be determined by a simple blood test. Treatment may be as simple as restricting fluid intake or may involve IV medication or the administration of salt.

Generally, correction of hyponatremia is done slowly and gradually, rather than rapidly. Rapid shifts in the body's sodium and fluid concentrations can also be dangerous.

Also Known As: hyponatremia, low sodium, low blood sodium, Transurethral resection syndrome, transurethral resection of the prostate syndrome, water intoxication

Alternate Spellings: TUR syndrome, TURP Syndrome

Examples: After having a transurethral resection of the prostate, the man appeared disoriented and began vomiting. His doctor determined that he was experiencing TURP syndrome.

Frequently Asked Questions

How long after surgery can TUR syndrome occur?

It can occur just a few minutes after surgery begins or several hours after surgery is completed.

How is TUR syndrome treated?

Treatment may include fluid restriction, administration of hypertonic saline (high in sodium), and/or nebulized levosalbutamol.

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  1. Huang S, Tsai C, Tseng C, et al. Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysisBMJ. 2019 Nov;367(1):15919. doi:10.1136/bmj.l5919

  2. Wu C-T, Huang Y-C, Chen W-C, Chen M-F. The predictive role of prostate-specific antigen changes following transurethral resection of the prostate for patients with localized prostate cancerCancers. 2020 Dec;13(1):74. doi:10.3390/cancers13010074

  3. Sterns RH. Treatment of severe hyponatremiaCJASN. 2018 Apr;13(4):641-649. doi:10.2215/CJN.10440917

  4. Institute for Quality and Efficiency in Health Care. Benign enlarged prostate: What are the pros and cons of surgery?. Updated January 2018.

  5. McGowan-Smyth S, Vasdev N, Gowrie-Mohan S. Spinal anesthesia facilitates the early recognition of tur syndromeCurr Urol. 2015 May;9(2):57-61. doi:10.1159/000442854

  6. Ishio J, Nakahira J, Sawai T, Inamoto T, Fujiwara A, Minami T. Change in serum sodium level predicts clinical manifestations of transurethral resection syndrome: a retrospective reviewBMC Anesthesiol. 2015 Apr;15(1):52. doi:10.1186/s12871-015-0030-z

  7. Hazarika P. TURP syndrome–A quick review and update. Indian Journal of Clinical Practice. 2020 Aug;31(3)224-228.

  8. International Anesthesia Research Society. OpenAnesthesia. TURP solutions – Neuro complications.

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