Transurethral prostatic resection syndrome--a new perspective: encephalopathy with associated hyperammonemia.

Encephalopathy developed in 3 patients after transurethral prostatic resection. Each patient had blood ammonia levels more than 10 times the upper limit of normal. Data supportive of a metabolic cause for encephalopathy subsequently were obtained in a prospective study of patients undergoing transurethral prostatic resection with glycine irrigation. It is suggested that a distinct subpopulation of patients experiencing transurethral prostatic resection syndrome can be identified. These patients exhibit encephalopathic symptoms and have concurrent marked elevation of blood ammonia levels.