Two cases of TURP syndrome with severe cardiovascular depression

We report two cases of TURP (transurethral resection of prostate) syndrome showing severe cardiovascular depression without any neurological disturbances. One patient developed hypotension (62/42 mmHg) and ST segment depression (-2.7 mm) on ECG during TURP. Another patient developed hypotension (60/38 mmHg) and nodal bradycardia (34.min-1) 15 minutes after the operation. No neurological signs were observed, despite severe hyponatremia (113 and 117 mEq.l-1, respectively). It is highly likely that hypovolemia and/or electrophysiological inhibition of pacemaker cell due to hyponatremia caused the symptoms. We emphasize that sudden circulatory depression as well as neurological disorders should be recognized as a major symptom of TURP syndrome.