In TURP with glycine irrigation, which electrolyte disturbance is most commonly observed if glycine is absorbed systemically?

In TURP with glycine irrigation, which electrolyte disturbance is most commonly observed if glycine is absorbed systemically?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypermagnesemia
• D. Hypocalcemia

Answer: (B)

Absorption of irrigation fluid during TURP introduces a large amount of free water that is not osmotically matched to plasma. Glycine 1.5% is a hypotonic solution, so when it enters the circulation it dilutes the blood sodium concentration. This dilutional hyponatremia lowers plasma osmolality and can lead to cerebral edema and TURP syndrome symptoms such as confusion, nausea, vomiting, seizures, or altered mental status. Hyperkalemia, hypermagnesemia, and hypocalcemia are not the typical disturbances from glycine irrigation. They would arise from different fluids or specific conditions, whereas the dilution of sodium due to hypotonic glycine absorption is the classic, most common electrolyte change in this setting.

Absorption of irrigation fluid during TURP introduces a large amount of free water that is not osmotically matched to plasma. Glycine 1.5% is a hypotonic solution, so when it enters the circulation it dilutes the blood sodium concentration. This dilutional hyponatremia lowers plasma osmolality and can lead to cerebral edema and TURP syndrome symptoms such as confusion, nausea, vomiting, seizures, or altered mental status.

Hyperkalemia, hypermagnesemia, and hypocalcemia are not the typical disturbances from glycine irrigation. They would arise from different fluids or specific conditions, whereas the dilution of sodium due to hypotonic glycine absorption is the classic, most common electrolyte change in this setting.