Glycine and transurethral resection

Fifty patients undergoing transurethral resection of the prostate were studied for evidence of glycine absorption and haemodilution. Plasma glycine levels increased substantially in nine patients and, in five, calculated irrigant fluid absorption ranged from 619-1582 ml; another patient had absorbed 1360 ml fluid with only a small rise in plasma glycine. Two illustrative case histories are presented. The role of glycine as an inhibitory neurotransmitter is discussed and the possibility of toxic mechanisms other than dilutional hyponatraemia is mentioned. Intravenous diuretics, hypertonic saline, and perhaps calcium salts, are recommended for the overt transurethral resection syndrome.