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

Abstract

The changes in water excretion during the first two months after hypophysectomy, and the effect of cortisone upon these changes, were studied in 22 patients with metastatic cancer of the breast and 2 patients with metastatic cancer of the prostate. Hypophysectomy induced a polyuria interrupted by a normal interphase which occurred about the end of the first week. The persistence of this polyuria after the third postoperative week was dependent on cortisone administration. The mean specific gravity of the daily urine was below 1.010 during cortisone administration, and was increased when cortisone was withdrawn. The response to a water load was abnormal when cortisone was not given. A 24-hour thirst test did not induce an increase in the specific gravity of the urine, whether cortisone was given or not. The data are interpreted as showing: that the presence of the posterior lobe is not a prerequisite for the "normal interphase" in man; that one of the mediators of the diuretic action of the anterior lobe of the hypophysis is the adrenocorticotropic hormone; and that antidiuretic hormone is probably present in hypophysectomized patients but is produced and/or released in an abnormal fashion.