A BLOOD CHEMICAL STUDY IN THE LOWER URINARY TRACT OBSTRUCTION
1957 Volume 48 Issue 2 Pages 79-92
Details
1957 Volume 48 Issue 2 Pages 79-92
In 63 cases of lower urinary tract obstruction, studies on blood chemistry and on water and sodium chloride balance were performed. The results were as follows:
(1) Before relief of the obstruction, 37 cases (58.8%) of all showed blood chemical abnormalities and the remaining (41.2%) were within normal limit.
(2) The most striking of all the blood chemical abnormalities in these cases was azotemia (27 cases), acidosis (20 cases) and hyperchloremia (16 cases), of which 9 cases showed only azotemia, 10 cases only electrolyte imbalance and remaining 18 cases azotemia combined with electrolyte imbalance.
(3) Most of blood chemical abnormalities were improved within 10 days after relief of the obstruction, regardless of the technique for relief. The improvement of azotemia, however, was slower than that of electrolyte imbalance. Accordingly it must be taken into consideration that no improvement of electrolyte imbalance within 10 days after relief of the obstruction suggests the irreversible renal impairment.
(4) The sorts of transient blood chemical changes after relief of the obstruction were different according to the techniques for relief. Retropubic prostatectomy led to the falls of sodium, chloride bicarbonate level in plasma, and the rise of nonprotein nitrogen level in blood, while urethral catheterization or suprapubic cystostomy led only to the falls of sodium and chloride level in plasma.
(5) Balance studies of water and sodium chloride following relief of the obstruction revealed that the exchanges of them were different according to the techniques for relief as follows: In cases of retropubic prostatectomy, obvious water and sodium chloride retention on the first day were followed by negative water and sodium chloride balance on the second day and then they reached a state of equilibrium on the third day. In cases of urethral catheterization or of suprapubic cystostomy, however, negative water and sodium chloride balance occured immediately on the first day and then they reached a state of equilibrium on the third day.
