泌尿器科領域に於ける17-Ketosteroidの研究 第III篇:尿中17-Ketosteroidの臨床的研究

Abstract

Summary The amount of 17-KS excreted into the urine was clinically investigated on the patients with various urogenital diseases. (1) Diseases on the kidney and ureter Most of these cases presented the normal 17-KS excretion into the uine, and any specificity has not been recognized on each disease. The average value of 17-KS in the urine, however, was highest in the neoplastic diseases, and next came the tuberculous diseases and the stone diseases in order. In generally, it seems that the severe cases presented a lower level within the normal limit. On the patients who recieved nephrectomy and well recovered, their 17-KS excretion into the urine was higher at the time of two weeks after the operation than before the operation. Precisely speaking, it increased on the first day after the operation, and then gradually decreased. And it increased again up to the preoperative level two weeks after the operation. (2) Diseases on the bladder Most of these also presented the normal 17-KS excretion into the urine, but it was obviously low in the severe cases. The change of 17-KS level in the urine before and after the total cystectomy was analogous to the cases nephrectomy was done. (3) Diseases on, the prostate gland On the patients with prosta tic hypertrophy and prostatic cancer, the average 17-KS value in the urine was normal. The patients with hypertrophy excreted much more 17-KS into the urine than that of prostatic cancer. In most of the patients whose 17-KS excretion were over or under the normal limit, their renal function was disturbed on PSP test. In most of the cases with hypertrophy the prostatectomy accompanied by hormonal therapy caused no influence upon 17-KS level in the urine. On the other hand, the increased 17-KS excretion into the u rine was observed on the patients whose general condition and renal function greatly improved after the treatment, In the cases of prostatic cancer, 17-KS level in the urine presented no change after the treatment. Generally speaking, an estrogen therapy caused decrease or no change, an androgen therapy caused increase, an surgical procedure upon the prostate gland caused a temporary decrease followed by recovering up to the preoperative level. (4) Other urogenital diseases No peculiar finding was observed in each disease. Bilateral epididymectomy caused a temporary decrease of 17-KS in the urine. Bilateral orchiectomy caused a more remarkable decrease of 17-KS in the urine and it more delayed to recover up to the preoperative level by bilateral orchiectomy than by unilateral orchiectomy. (5) Sexual dysfunction 17-KS in the urine of the patients with this disease was under the normal limit or lower within the normal limit even at highest. In almost all of the cases which were administrated gonadotropic and androgenic hormones, 17-KS excretion into the urine gradually increased with simultaneous improvement of their clinical symptoms. And it seems that the treatment with androgenic hormone for male infertility promoted their spermatogenesis.