1964 Volume 55 Issue 9 Pages 882-898
In the urology area, when these kinds of diseases -renal tumor, prostate hypertrophy, cancer of prostate and cancer of urinary bladder, which are necessary to be operated upon for, are treated, disorders of renal function are perceived in pretty degenerated conditions. Though they are different from one another in their degree of aggravation, these disorders are discovered even before operation. In this respect, these disorders are different from other surgical ones. These disorders are found rather in aged persons than in young ones. The operation for these diseases gives metabolism a considerable change, and on this occasion the excretion of potassium increased in the urine after operations, as one of the fundamental changes in the waterelectrolyte metabolism. After the impaired of renal function and aged persons undergo an operation, it can be supposed sufficiently that their serum potassium and Ke will undergo a greater change than those of healthy renal and younger persons.
Before and after operation, practicing nephrectomy (renal tumor), ileocystoplasty after Tasker modified methode and Scheele's methode (remaining kidney tuberculosis and contracted bladder), partial cystectomy (cancer of the urinary bladder), total cystectomy with ureterocutaneostomy (cancer of the urinary bladder), and adrenalectomy (primary aldosteronism), I have recently pursued the change of serum potassium and total exchangeable potassium and brought about the following results:
1. With the change of serum potassium shown in the cases of the impaired renal function before operation, only one case showed hyperkalemia, and all the others were in the normal range, and the difference from the cases of normal renal function could not be found. In one or two weeks after operation, a few of the cases of cancer of the urinary bladder showed hypokalemia, but all the others were almost in the normal range.
In these caces, as compared with the cases of normal renal function, Ke was apt to fall through the period before and after operation.
2. A definite tendency was not shown in the change of serum potassium in hypertension occured after operation, and the same result was also brought about in the case of Ke.
3. Serum potassium of 5 cases of operation performed on patients for renal tumor was in the normal range in all the cases before operation, though it showed a tendency to hyperkalemia in 2 cases of them after opeartion. In aged patients that showed the impairment of renal function, Ke was low for 2 weeks after operation, but in the other 3 cases, it was in the normal range both before and after operation.
In all 5 cases of renal tumor, tumor was comparatively small. These cases, except one case of an aged patient whose renal function was impaired were those of young patients whose renal function was normal. Accordingly it is assumed that in these cases the falling of Ke was small after operation.
4. Out of the serum potassium of 10 cases, in which i leocystoplasty after Tasker modified methode and Scheele's methode was executed for the contracted bladder, that of 8 cases was normal before operation, and that of 2 cases showed slight hyperkalemia before operation.
In 4 days after operation, about half of the cases showed hyperkalemia, but for 7 weeks almost all the cases were changed into the normal range.
Ke in almost all the cases was in the normal range before operation, and it has fallen more in 4 days after operation, as compared before operation, but it was still in the normal range. In a week after operation it brought about a change within the normal range, except one case with the impairment of renal function.
In this procedure, urine is poured into the isolated ileum. Potassium was stable in its change, as compared with the case of Sigma bladder.
5. Serum potassium in the case, in which partial cystectomy was executed for cancer of the urinary bladder was all in the normal range before operation, but 3 out of 7
