Delayed Presentation of Transurethral Resection of Prostate Syndrome: A Case Presentation from a Rural Referral Hospital

Abstract

The authors report a case of delayed transurethral resection of prostate (TURP) syndrome. A 60-year-old man was diagnosed with obstructive prostatic enlargement where conservative medical treatment failed, and therefore he was scheduled for standard TURP under spinal anaesthesia. Six days post-discharge, the patient presented at the emergency department with signs of clot retention and transient hypertension with difficulty in passing urine, suprapubic pain, and abdominal distention; clot evacuation was endoscopically done. However, 5 days post-clot evacuation (11 days post-TURP), the patient presented signs of TURP syndrome with hypertension, difficulty breathing, and reduced oxygen saturation. Electrolyte analysis revealed hyponatraemia (sodium concentration of 105 mmol/L), hypokalaemia (potassium concentration of 2.7 mmol/L), and kidney injury with a serum creatinine level of 157.3 mmol/L. Medical treatment consisted of hypertonic saline 3%, intravenous potassium chloride, volume expansion, oxygen therapy, and renal haemodialysis. The case presented here describes a typical delayed TURP syndrome, a rare occurrence which was diagnosed and treated. The patient was discharged from the hospital for the second time without complications.