Nonoliguric renal failure after transurethral resection of prostate

Purpose: To define the relation of nonoliguric renal failure to transurethr al resection of the prostate (TURP), its clinical importance, and predictiv e factors. Patients and Methods: The files of 439 patients who had undergone TURF at H acettepe University School of Medicine, Department of Urology, between Janu ary 1991 and 1994 were analyzed. The patients were divided into three group s according to postoperative serum creatinine concentration and the presenc e of clinical signs and symptoms of TUR syndrome (Group I: patients with pr eoperative and postoperative creatinine in the normal range; Group II: pati ents suffering nonoliguric renal failure; and Group III: patients with TUR syndrome). The data of the groups were compared in terms of factors influen cing nonoliguric renal failure, Results: The mean postoperative concentrations of sodium, blood urea nitrog en, creatinine, and albumin in Groups LI and III were statistically differe nt from those in Group I (P < 0.001). There was a moderate relation between hyponatremia and the occurrence of nonoliguric renal failure (r(s) = -0,56 ). Capsule perforation increased the risk of nonoliguric renal failure 10.6 fold, All of the patients were managed by a conservative approach, and non e of the patients died or progressed to end-stage renal disease. They were all discharged with a mean hospitalization period of 7 days and normal rena l function tests. Conclusion: Nonoliguric renal failure was thought to be an early step in th e pathophysiology of TUR syndrome with acute renal failure, It is an asympt omatic clinical picture that is undiagnosed unless laboratory examinations are performed. A conservative therapeutic approach is enough.