Hyponatremia and fluid overload--the so-called TURP Syndrome--is a rare but well-understood complication of endoscopic resection of the prostate caused by rapid absorption of irrigating fluids from venous sinuses opened during the surgery. A similar syndrome occurring during endoscopic resection of the uterine mucosa has been postulated but only rarely described. New equipment and surgical techniques have recently been developed that allow for more invasive and extensive hysteroscopic surgery, which will inevitably lead to an increased incidence of this complication. We report the occurrence of a case of acute pulmonary edema occurring intraoperatively during hysteroscopic surgery, complicated postoperatively by severe hyponatremia. Anatomic and physiological causes of this syndrome are discussed, and recommendations are offered for avoiding and treating this potentially lethal complication.
PMID: 9866484 [Pubmed - MEDLINE]