Amino Acids

, Volume 11, Issue 1, pp 43–53 | Cite as

Rabbit model simulating transient hyperglycinemia following transurethral prostatectomy

  • P. Gentens
  • P. P. De Deyn
  • R. D'Hooge
  • H. Pei
  • M. -J. Tassignon
  • S. Van Dromme
  • B. Marescau


Glycine was intravenously injected in rabbits and resulted in a dose dependent hyperglycinemia. A dose of 10mmol/kg was sufficient to achieve plasma levels of 10 to 16mM comparable to serum levels in patients at the end of a transurethral prostatectomy. The experiments documented that hyperglycinemia is associated with a significant increase of this substance in tissues outside the plasma compartment. Glycine loading resulted in a tenfold elevation of this amino acid in cerebrospinal fluid 10 minutes after injection. In retina and vitreous humor a five- to tenfold increase in glycine content was observed at 10 minutes post injection while in the anterior chamber fluid the maximum increase appeared at 30 minutes.

Significant increases of the glycine content were found in different cerebral structures at 30 minutes post administration.

The significant elevations of this neurotransmitter within the central nervous system are prerequisites for possible toxic side effects in the course of transurethral prostatectomy (TURP). Hyperglycinemia might be involved in the pathogenesis of visual disturbances following transurethral prostatectomy and the other neurological complications of TURP syndrome. Our observations add more evidence to this hypothesis.


Amino acids Transurethral prostatectomy Transurethral prostatectomy syndrome Hyperglycinemia Animal model 


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  1. Appelt GL, Benson GS, Corriere JN (1979) Transient blindness. Unusual initial symptom of transurethral prostatic resection reaction. Urology 4: 402–404Google Scholar
  2. Aprison MH, Daly EC (1978) Biochemical aspects of transmission in inhibitory synapses. The role of glycine. Adv Neurochem 3: 203–294Google Scholar
  3. Belgum JH, Dvorak DR, McReynolds JS (1984) Strychnine blocks transient but not sustained inhibition in mudpuppy retinal ganglion cells. J Physiol 354: 273–286Google Scholar
  4. Cashman JN (1990) Visual disturbance after transurethral resection of the prostate. Anaesthesia 45: 691–692Google Scholar
  5. Compton RP, Hood WF, Monahan JB (1990) Evidence for a functional coupling of the NMDA and glycine recognition sites in synaptic plasma membranes. Eur J Pharmacol 188: 63–70Google Scholar
  6. Creevy CD (1948) The importance of hemolysis during transurethral prostatic resection; a clinical investigation. J Urol 59: 1217–1232Google Scholar
  7. Defalque RJ, Miller DW (1975) Visual disturbances during transurethral resection of the prostate. Can J Anaesth 22: 620–621Google Scholar
  8. Ellis RE, Carmichael JK (1991) Hyponatremia and volume overload as a complication of transurethral resection of the prostate. J Fam Pract (USA) 33: 89–91Google Scholar
  9. Frederick JM, Rayborn ME, Hollyfield JG (1984) Glycinergic neurons in the human retina. J Comp Neurol 227: 159–172Google Scholar
  10. Ghanem AN, Ward JN (1990) Osmotic and metabolic sequelae of volumetric overload in relation to the TUR syndrome. Br J Urol 66: 71–78Google Scholar
  11. Hahn R, Berlin T, Lewenhaupt A (1988) Irrigating fluid absorption and blood loss during transurethral resection of the prostate studied with a regular interval monitoring (RIM) method. Scand J Urol Nephrol 22: 23–30Google Scholar
  12. Hahn RG (1988) Hallucination and visual disturbances in transurethral prostatic resection. Intensive Care Med 14: 668–671Google Scholar
  13. Hamilton Stewart PA, Barlow IM (1989) Metabolic effects of prostatectomy. J R Soc Med 82: 725–728Google Scholar
  14. Henderson DJ, Middleton RG (1980) Coma from hyponatremia following transurethral resection of prostate. Urology 15: 267–271Google Scholar
  15. Hendrickson AE, Koontz MA, Pourcho RG, Sarthy PV, Goebel DJ (1988) Localization of glycine-containing neurons in the Macaca monkey retina. J Comp Neurol 273: 473–487Google Scholar
  16. Hoekstra PT, Kahnoski R, McCamish MA, Bergen W, Heetderks DR (1983) Transurethral prostatic resection syndrome — a new perspective: encephalopathy with associated hyperammonemia. J Urol 130: 704–707Google Scholar
  17. Hulten J, Sarma VJ, Hjertberg H, Palmquist B (1991) Monitoring of irrigating fluid absorption during transurethral prostatectomy. Anaesthesia 46: 349–353Google Scholar
  18. Kaiser R, Adragna MG, Weis R, Williams D (1985) Transient blindness following transurethral resection of the prostate in an achondroplastic dwarf. J Urol 133: 685–686Google Scholar
  19. Kirby AW (1979) The effect of strychnine, bicuculline and picrotoxin on X and Y cells in the cat retina. J Gen Physiol 74: 71–84Google Scholar
  20. Kubo T, Kihara M (1987) Evidence for the presence of GABA-ergic and glycine-like systems responsible for cardiovascular control in the Nucleus tractus solitarii of the rat. Neurosci Lett 74: 331–336Google Scholar
  21. Marc RE, Liu WL (1985) (3H) Glycine-accumulating neurons of the human retina. J Comp Neurol 232: 241–260Google Scholar
  22. Mizutani AR, Parker J, Katz J, Schmidt J (1990) Visual disturbances, serum glycine levels and transurethral resection of the prostate. J Urol 144: 697–699Google Scholar
  23. Nesbit RM, Glickman SI (1948) The use of glycine solution as an irrigating medium during transurethral resection. J Urol 59: 1212–1216Google Scholar
  24. Norlen H, Allgen LG, Vinnars E, Bedrelidou-Classon G (1986) Glycine solution as an irrigating agent during transurethral prostatic resection. Scand J Urol Nephrol 20: 19–26Google Scholar
  25. Oester A, Madsen PO (1969) Determination of absorption of irrigating fluid during transurethral resection of the prostate by means of radioisotopes. J Urol 102: 714–719Google Scholar
  26. Pourcho RG, Goebel DJ (1990) Autoradiographic and immunocytochemical studies of glycine containing neurons in the retina. In: Ottersen OP, Storm-Mathisen J (eds) Glycine neurotransmission. John Wiley, New York, pp 355–389Google Scholar
  27. Rhymer JC, Bell TJ, Perry KC, Ward JP (1985) Hyponatraemia following transurethral resection of the prostate. Br J Urol 57: 450–452Google Scholar
  28. Russell D (1990) Painless loss of vision after transurethral resection of the prostate. Anaesthesia 45: 218–221Google Scholar
  29. Ryder KW, Olson JF, Kahnoski RJ, Karn RC, Oei TO (1984) Hyperammonemia after transurethral resection of the prostate: a report of 2 cases. J Urol 132: 995–997Google Scholar
  30. Schmid K, Böhmer G, Gebauer K (1991) Glycine receptor-mediated fast synaptic inhibition in the brainstem respiratory system. Respir Physiol 84: 351–361Google Scholar
  31. Shepard RL, Kraus SE, Babayan RK, Siroky MB (1987) The role of ammonia toxicity in the post transurethral prostatectomy syndrome. Br J Urol 60: 349–351Google Scholar
  32. Thomson AM, Walker VE, Flynn DM (1989) Glycine enhances NMDA-receptor mediated synaptic potentials in neocortical slices. Nature 338: 422–423Google Scholar
  33. Wang JM, Creel DJ, Wong KC (1989) Transurethral resection of the prostate, serum glycine levels, and ocular evoked potentials. Anesthesiology 70: 36–41Google Scholar
  34. Werman R, Davidoff RA, Aprison MH (1967) Inhibition of motoneurones by iontophoresis of glycine. Nature 214: 681–683Google Scholar
  35. Werman R, Davidoff RA, Aprison MH (1968) Inhibitory action of glycine on spinal neurons in the cat. J Neurophysiol 31: 81–95Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • P. Gentens
    • 1
  • P. P. De Deyn
    • 2
  • R. D'Hooge
    • 2
  • H. Pei
    • 2
  • M. -J. Tassignon
    • 3
  • S. Van Dromme
    • 1
  • B. Marescau
    • 2
    • 4
  1. 1.Department of UrologyUniversity of Antwerp (U.I.A.)AntwerpBelgium
  2. 2.Laboratory of Neurochemistry and Behavior and Department of Neurology A.Z. Middelheim, O.C.M.W. Medical Research FoundationUniversity of Antwerp (U.I.A.)AntwerpBelgium
  3. 3.Department of OphtalmologyUniversity of Antwerp (U.I.A.)AntwerpBelgium
  4. 4.Department of Medicine-UIALaboratory of Neurochemistry and Behavior-BBSAntwerpBelgium

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