Activity-dependent regulation of cortical cell numbers: Role of neuronal activity in cortical circuit formation.

Hyponatraemia is the most common electrolyte disorder in hospital practice and is associated with increased morbidity and mortality []. TURP syndrome classically results from systemic absorption of hypotonic irrigation fluid during endoscopic prostate surgery [, ]. Although irrigation-fluid absorption is well recognised during operative urological procedures, similar complications associated with prolonged non-operative bladder washouts are rarely reported. Radiation cystitis is characterised by chronic inflammation, ischaemia, friable neovascularization and urothelial ulceration, which disrupt the urothelial permeability barrier []. Previous reports have described fatal fluid overload, hyperchloraemic metabolic acidosis and haemolysis associated with bladder irrigation [], but severe dilutional hyponatraemia remains rarely reported outside the operative setting. We report a case of severe dilutional hyponatraemia following prolonged sterile water bladder washouts in a patient with radiation cystitis, producing a TURP-like syndrome in the absence of surgery. Trend in serum sodium concentration during prolonged sterile water bladder washouts. Serum sodium progressively declined from 132 mmol/L on admission to a nadir of 112 mmol/l on day 8 during prolonged sterile water bladder washouts and continuous bladder irrigation. Serum sodium subsequently recovered following cessation of bladder washouts and bladder irrigation. Clinical timeline with daily washout and CBI status.