Clinical Report: Incidence and Risk Factors of Post-TURP Hypothermia

Overview

This systematic review and meta-analysis evaluated the prevalence and contributing factors of intraoperative hypothermia (IPH) in patients undergoing transurethral resection of the prostate (TURP). The pooled data from 10 moderate-quality studies indicate a high prevalence of IPH, ranging widely across regions and management strategies, with significant risk factors including irrigation fluid temperature, hemorrhage, patient age, and operation duration.

Background

Benign prostatic hyperplasia (BPH) is a common condition characterized by prostate enlargement, often treated surgically by TURP, the gold standard procedure. TURP patients are particularly susceptible to intraoperative hypothermia due to factors such as extensive irrigation with room temperature fluids, older age, and diminished thermoregulatory capacity. IPH, defined as core body temperature below 36.0 °C during surgery, is associated with adverse outcomes including increased infection risk, delayed healing, and prolonged anesthesia effects. Despite its clinical importance, the true incidence and risk factors of IPH in TURP patients remain unclear due to variable prevalence reports and limited pooled analyses.

Data Highlights

Key Findings

• IPH prevalence in TURP patients varies widely from 7% to 90%, with a pooled estimate indicating a high overall incidence.
• Use of room temperature irrigation fluids during TURP significantly contributes to heat loss and risk of hypothermia.
• Older age and diminished thermoregulatory capacity increase susceptibility to IPH and delay temperature recovery postoperatively.
• Longer operation times and intraoperative hemorrhage are associated with higher IPH risk.
• Psychological factors such as preoperative anxiety may exacerbate hypothermia risk.
• Current studies show moderate methodological quality with limited reporting on confidence intervals and blinding.

Clinical Implications

Clinicians should prioritize temperature management strategies during TURP, including warming irrigation fluids and minimizing operation time when possible. Preoperative assessment should consider patient age and comorbidities to identify those at higher risk for IPH. Implementing evidence-based protocols aligned with NICE Guideline 65 can reduce hypothermia incidence and improve postoperative outcomes.

Conclusion

IPH is a common and clinically significant complication in TURP patients, influenced by multiple modifiable and non-modifiable factors. Enhanced perioperative temperature management and targeted interventions based on identified risk factors are essential to improve patient safety and recovery.

References

1. NICE Guideline 65 -- Prevention and Treatment of Hypothermia in Adults Undergoing Surgery
2. Loney et al. -- Quality Assessment Tool for Prevalence Studies