Objective To explore the clinical significance of pulse pressure variability （PPV） in early prevention and diagnosis of prostate resection syndrome by observing the changes in PPV during transurethral resection of the prostate. Methods Eighty patients undergoing transurethral resection of the prostate （TURP） under general anesthesia from March to April 2023 were randomly divided into a control group and an observation group， with 40 patients in each group. The control group underwent routine monitoring of invasive blood pressure， while the observation group continued to monitor PPV in addition to invasive blood pressure monitoring. Observe and record the hemodynamic parameters， electrolyte Na⁺， K⁺，CL ^-， Changes in hemoglobin （Hb） and hematocrit （Hct）， recording surgical time， intraoperative lavage fluid dosage， and occurrence of dilutive hyponatremia （TURS）. Results One patient in the observation group experienced two unexplained drops in blood pressure and heart rate during surgery， and was diagnosed with TURS based on blood gas analysis. Among them， the observation group showed a decreasing trend in PPV with the prolongation of surgery time. PPV gradually decreased at 45 ~ 60 minutes after surgery， and at 90 minutes after surgery， PPV decreased significantly compared to preoperative levels. Among them， 6 patients had a 50% decrease in PPV compared to preoperative levels. For patients with significantly reduced PPV， immediate treatment was given 10 ~ 20 mg of furosemide and 10 mg of dexamethasone. By the end of surgery， PPV had basically recovered to preoperative levels. Both groups of patients showed varying degrees of decrease in Na⁺， K⁺， Hct， and Hb levels. Conclusions PPV can reflect the volume status of patients. When PPV decreases by more than 50% compared to preoperative levels and there are unexplained hemodynamic changes and abnormal clinical manifestations during surgery， it is necessary to be vigilant and handle them promptly to reduce and prevent the occurrence of TURS.