Abstract
Changes of pre- and postoperative levels of serum potassium (K) and total exchangeable potassium (Ke) have been measured on 44 patients admitted to the Urology Department, University Hospital, Tohoku University for the past two years. The data was then analysed for possible interrelationship between the serum potassium levels and total exchangeable potassium:
The results as follows:
1) No appreciable change in K levels was observed in 6 patients operated on for unilateral nephroureterolithiasis. Slight depletion of Ke was noticed after the operation, although remaining within the normal limits. These levels of K and Ke were found to be both normal limits throughout pre- and postoperative periods. The correlation of K and Ke, therefore, was well established. Nephro- and ureterolithotomy is supposed to be only a slight operative encroachment on the patients, hardly influencing the metalism of potassium.
2) 23 cases of prostatic hypertrophy which had retropubic prostatectomies showed normal serum potassium levels thoughout hospitalization, although marked fluctuation was seen in cases of impaired renal function in some cases. Decreased Ke levels were evident even before the operation. In more than half of the cases Ke was reduced below the normal level in 4 to 7 postoperative days, requiring more than two weeks to return to normal. In about three fourths of cases, both K and Ke were well maintained within normal limits with a few exceptions. In 4 to 7 days after the operation, two thirds of the cases showed diminished Ke levels in the face of normal serum potassium level, although the correlationship was still maintained. These alterations of K and Ke in these cases were rather noticeable, which leads to us to a conclusion that they resulted from senility and impaired renal function of the patients as well as effects caused by the operation.
3) With cases of prostatic cancer, preoperative levels of serum potassium of 8 patients remained normal. All these patients had total prostatectomies. In a few cases decreased K levels were shown one week after the operation. In some cases its diminition was still noticeable in 5 to 6 weeks post-operatively. More than one third of the case showed a decrease of Ke to abnormally low levels in preoperative period. The reduction was evident in almost all cases 4 days after the operation, some of which remained within abnormal Ke level for 5 to 6 weeks. As to the correlationship of K and Ke, some cases failed to maintain it due to the preoperative existence of Ke depletion. The reprocity was lost in many cases 4 to 7 days after operation, resulting from more pronounced reduction of Ke level than that of K, although sometimes K levels remainded normal. In 5 to 10 weeks after the operation, in half of the cases the K and Ke approached normal level and the another half reestablished the correlation of K and Ke only after both levels were restored to normal.
Observing the results of these cases, marked diminition of both K and Ke levels is attributed to the existence of changes caused by the carcinomas, as well as old age, as pointed out in the cases of prostatic hypertrophy.
4) 6 cases of carcinoma of urinary bladder which underwent total cystectomies with uretro-sigmoidostomies showed normal K level in preoperative period, but 2 or 3 of them developed hypokalemia 1 to 2 weeks after the operation, some of them required normal K levels, others recovered poorly. Abnormal preoperative depletion of Ke was noticed in one third of cases and all the cases examined showed low Ke levels on the 4 days after the operation, continuing the same phase for 1 to 10 weeks. Half of the cases maintained the correlationship of K and Ke levels well in preoperative period. However, the relativity was lost 4 days after the operation, resulting from the decreased Ke levels. These state continued for 5 to 10 weeks. In a few cases the correlationship of K and Ke was kept in the state of decreased levels of b
