Why are steroids administered before a bilateral adrenalectomy?

Steroids are administered before a bilateral adrenalectomy primarily to compensate for the sudden lack of adrenal hormones that will occur after the removal of the adrenal glands. The adrenal glands produce critical hormones, including cortisol, aldosterone, and adrenal androgens, which play significant roles in metabolism, immune response, and fluid balance.

Following the surgery, the body will not be able to produce these hormones naturally due to the removal of the glands. Preoperative steroid administration helps to ensure that adequate hormone levels are maintained, which is crucial for the patient's physiological stability and recovery. This practice reduces the risk of adrenal crisis, a potentially life-threatening condition caused by insufficient levels of cortisol in the body.

The other options do not effectively capture the primary reason for steroid administration in this context. While glycogen accumulation, inflammatory action, and urinary excretion processes are important factors in the overall management of a patient's health, they do not directly relate to the immediate hormonal support needed after the adrenal glands are removed. Hence, the focus remains on compensating for the loss of adrenal hormone production, which substantiates the rationale for administering steroids prior to the procedure.