T.U.R. (transurethral resection) syndrome is due to
**Core Concept**
T.U.R. (transurethral resection) syndrome is a clinical condition that occurs after transurethral resection of the prostate (TURP) surgery. It is characterized by a complex pathophysiology involving the release of vasoactive substances, fluid absorption, and subsequent hypotension. The syndrome is a result of the absorption of these substances into the systemic circulation.
**Why the Correct Answer is Right**
The correct answer involves the release of vasoactive substances, including histamine, bradykinin, and prostaglandins, during the resection procedure. These substances lead to vasodilation and increased vascular permeability, resulting in fluid absorption and hypotension. The absorption of these substances into the systemic circulation causes a decrease in blood pressure, leading to symptoms such as hypotension, bradycardia, and respiratory distress.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because TUR syndrome is not primarily caused by electrolyte imbalances, although electrolyte disturbances can occur as a secondary effect of fluid absorption.
**Option B:** This option is incorrect because TUR syndrome is not caused by bleeding or hemorrhage during the resection procedure, although significant bleeding can occur in some cases.
**Option C:** This option is incorrect because TUR syndrome is not caused by the release of inflammatory mediators during the resection procedure, although inflammation can occur as a secondary effect of tissue trauma.
**Clinical Pearl / High-Yield Fact**
The key to diagnosing TUR syndrome is to recognize the triad of symptoms: hypotension, bradycardia, and respiratory distress. This triad is often referred to as the "classical" presentation of TUR syndrome.
**Correct Answer: C. Release of vasoactive substances**