SYMPTOMS OF THE TRANSURETHRAL RESECTION SYNDROME USING GLYCINE AS THEIRRIGANT

We evaluated signs and symptoms of the transurethral resection syndrom e recorded during and after 273 transurethral prostatic resections per formed at 2 hospitals between 1984 and 1993. Glycine solution was used as the irrigant and ethanol served as a tracer for fluid absorption. The incidence and severity of symptoms that could possibly be related to the syndrome increased progressively as more glycine solution was a bsorbed. Patients who absorbed 0 to 300 ml. of glycine solution had an average of 1.3 such symptoms. This number increased to 2.3 when 1,001 to 2,000 ml. were absorbed, 3.1 when 2,001 to 3,000 ml. were absorbed and 5.8 for volumes greater than 3,000 ml. Nausea and vomiting occurr ed significantly more often when 1,001 to 2,000 ml. were absorbed comp ared to no absorption. Confusion and arterial hypotension were other p rominent signs of fluid absorption, whereas hypertension was not. The severity of symptoms was markedly aggravated when more than 3,000 ml. were absorbed. Extravasation resulted in higher risks of bradycardia, hypotension and failed spontaneous diuresis postoperatively than absor ption by the intravascular route.