HYPOPHYSECTOMY IN MAN: EFFECT ON WATER EXCRETION DURING THE FIRST TWO POSTOPERATIVE MONTHS*

Abstract

THE role of the hypothalamic-hypophyseal axis in water excretion has been extensively studied in animals. Our knowledge on this subject in man is principally derived from observations in pathologic conditions involving this area. The significance of such observations may, however, always be questioned, as the extent of the damage cannot often be defined with accuracy. Hypophysectomy in man (1, 2) provides material in which the influence of the hypophysis on water excretion can be studied under well defined conditions. The aim of the present paper is to report on the changes in the daily urine volume and the concentrating and diluting ability of the kidney of hypophysectomized patients during the first two months after operation. In the selection of hypophysectomized patients for the present study, those subjects were excluded who showed an incomplete hypophysectomy, altered kidney function, extensive liver metastases or large collections of fluid in the serous cavities. The material consisted of 24 patients, 4 males and 20 females, between the ages of 30 and 69 years. Two of the males had metastatic cancer of the prostate; all the other patients had advanced metastatic cancer of the breast. The hypophysectomy was performed as described previously (2). According to this procedure a silver clamp was put in the middle of the hypophyseal stalk, which was then severed at a point distal to the clamp.