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Study of hypotonic polyuria after trans-sphenoidal pituitary adenomectomy

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Abstract

We have studied the postoperative diuresis patterns in 116 patients following the removal of a pituitary adenoma using the trans-sphenoidal approach. We observed a normal diuresis (ND) in 55 patients and a hypotonic polyuria (HP) in 61 patients, consisting of water elimination (WE=45 cases) and transient diabetes insipidus (DI=16 cases). We investigated the problem of predicting these patterns from eight pre-operative factors by applying stepwise logistic discriminant analysis. We demonstrated that DI was significantly associated with a posterior localization of the adenoma in the pituitary gland and that WE was more frequently observed in cases of suprasellar expansion, in young patients, and in prolactin secreting tumors. Finally, we discuss the pathogenic role of these factors in the occurrence of HP, taking into account inhibition of vasopressin secretion and possible fluid overload.

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References

  1. Abboud CF, Laws ER (1979) Clinical endocrinological approach to hypothalamic-pituitary disease.J Neurosurg51:271

    Google Scholar 

  2. Albert A (1982) On the use and computation of likelihood ratios in clinical chemistry. Clin Chem 28:1113

    Google Scholar 

  3. Albert A, Anderson JA (1984) On the existence of maximum likelihood estimates in logistic regression models. Biometrika 71:1

    Google Scholar 

  4. Albert A, Chapelle JP, Smeets JP (1981) Stepwise probit discrimination with specific application to short-term prognosis in acute myocardial infarction. Comp Biomed Res 14:139

    Google Scholar 

  5. Beaufils F, Vourch G (1978) Surveillance endocrino-métabolique après chirurgie de la région hypotalamo-hypophysaire. Anesth Anal Réan 35:301

    Google Scholar 

  6. Guiot G, Oproiu A, Hertzog E, Fredy D (1969) In: Encyclopédie médico-chirurgicale, 17:340 A10, Paris

  7. Hardy J, Robert F, Somma M, Vezima JL (1973) Acromégalie-Gigantisme. Traitement chirurgical par exérèse transsphenoïdale de l'adénome hypophysaire. Neurochirurgie,Paris, 19 [suppl 2]:35

    Google Scholar 

  8. Helderman JH, Vestel RE, Rowe JW, Tobin JD, Andres R, Robertson GL (1978) The response to arginine in intravenous ethanol and hypertonic saline in man:the impact of aging. J Geront 33:39

    Google Scholar 

  9. Horrobin DF, Lhoyd JJ, Lipton A, Burstyn PG, Durkin N, Muirui KL (1971) Actions of prolactin on human renal function. Lancet 2:352

    Google Scholar 

  10. Maffly RH (1977) Diabetes Insipidus. In: Andréoli Th E, Grantham JJ, Rector FC Jr (eds) Disturbances in body fluid osmolality. American Physiological Society, p 285

  11. Randall RV, Clark EC, Dodge HW, Love JG (1960) Polyuria after operation for tumors in the region of the hypophysis and hypothalamus. J. Clin Endocr Métab 20:1614

    Google Scholar 

  12. Randall RV, Laws Jr ER, Abboud Ch F, Ebersold NJ, Kao PC, Scheithaner BW (1983) Trans-sphenoïdal microsurgery treatment of prolactin producing pituitary adenomas. Results in 100 patients. Mayo Clin Proc 58:108

    Google Scholar 

  13. Rowe JW, Minaker KL, Sparrow D, Robertson GL (1982) Age-related failure of volume pressure mediated vasopressin release. J Clin Endocr Métab 54:661

    Google Scholar 

  14. Shucart WA, Jackson I (1976) Management of diabetes insipidus in neurosurgical patients. J Neurosurg 44:65

    Google Scholar 

  15. Verbalis JG, Robinson AG, Moses AM (1985) Postoperative and post-traumatic diabetes insipidus. In: Czernichow P, Robinson AG (eds) Diabetes insipidus in man. Karger, Basel, p 256

    Google Scholar 

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Hans, P., Stevenaert, A. & Albert, A. Study of hypotonic polyuria after trans-sphenoidal pituitary adenomectomy. Intensive Care Med 12, 95–99 (1986). https://doi.org/10.1007/BF00254519

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