Severe Acute Hyponatriemia and Transurethral Resection of the Prostate – Case Presentation and Overview of Literature

The article presents a patient who developed severe acute hyponatremia during transuret­hral prostate gland resection. This case is interesting because of the sudden onset as well as the severity of the initial clinical presentation of hyponatremia, which developed despite meti­culous supervision and routine preventive measures. Initial laboratory measurement revea­led an extremely low serum sodium level. Combined with the clinical picture (seizures, loss of consciousness), this indicated severe acute hyponatremia, which was then promptly trea­ted. Hyponatremia is the electrolyte disturbance most commonly found in clinical practice and its acute form is seen mostly following transurethral prostate resection. Its other com­mon causes include diuretic use, diarrhea, heart failure, and renal disease. Its clinical mani­festations are primarily neurologic, especially in the case of acute hyponatremia, and they mainly include headache, confusion, and stupor, but seizures and coma may also occur. The treatment involves restriction of water intake and promotion of water loss, as well as repla­cement of any sodium deficit and treatment of the cause.