[Coma during transurethral resection of the prostate]

Abstract

Two cases of coma occurring during transurethral resection of the prostate are reported. The 76 and 85-year-old patients lapsed into coma, ranking 9 and 8 on the Glasgow scale, respectively 90 and 120 min after the start of the resection, without any previous haemodynamic alterations. In one patient, coma occurred when the urethral catheter became blocked with fragments of prostates. In the other, coma was initiated by a rupture of the prostatic capsule, with passage of washing fluid (1.5% glycine solution) into the peritoneal cavity. The role played by acute hyponatraemia (128 and 123 mmol.l-1 respectively) and glycine poisoning (10,188 and 11,840 mmol.l-1 respectively) are discussed. These cases underline the interest of regional anaesthetic techniques, allowing an early diagnosis and a rapid surgical procedure which will avoid a worsening of the condition.