Successful Treatment of Pulmonary Edema Caused by Transurethral Resection of the Prostate Syndrome

BACKGROUND: Transurethral resection of the prostate (TURP) syndrome is a complication of transurethral resection of the prostate procedure. The incidence of TURP syndrome ranges from 0.78% to 1.4%. This syndrome is caused by excessive absorption of electrolyte-free and hypotonic washing solution. The fluids absorb into the circulation, which leads to heart failure, hyponatremia, and a decrease in serum osmolality. Cerebral edema, coma, pulmonary edema, cardiovascular collapse, and even death are common complications. CASE PRESENTATION: We report a patient who suffered severe TURP syndrome after transurethral resection of the prostate procedure. Clinical manifestations were pulmonary edema and respiratory failure. The concentration of Na(+) was 112.6 mmol/l, which was severe hyponatremia. The serum osmolality pressure was 234mOsmol/kg, pH was 7.23, pO(2) was 45mmHg and pCO(2) was 44mmHg. The patient had successfully recovered after being used CPAP-PSV Pro breathing through a mask with + 5cmH(2)O of PEEP, 8cmH(2)O of supporting pressure, 70−100% of FiO(2), 20mg furosemide of intravenously, 150 mL of 3% NaCl, and 100mL natribicarbonate 8.4%. CONCLUSION: TURP syndrome is a life-threatening complication of transurethral resection of the prostate procedure, which is caused by excessive absorption of electrolyte-free and hypotonic washing solution. Therefore, the patient should be monitored seriously, diagnosed early, and treated promptly.