Ambulatory, Office-based, and Geriatric UrologyPhenazopyridine: A Preoperative Way to Identify Ureteral Orifices
Section snippets
Methods
Adult patients at the Albany Stratton VA Medical Center were prospectively enrolled. All patients had a preoperative metabolic panel drawn that was reviewed to determine eligibility for the study. Exclusion criteria included renal insufficiency (creatinine clearance <50 mL/min), severe hepatitis or severe liver disease, glucose-6-phosphate dehydrogenase deficiency, previous hypersensitivity to phenazopyridine, or pregnancy. The study was approved by the internal review board.
In phase 1,
Phase 1
Twelve patients were enrolled in phase 1. Seven patients were excluded (4 forgot to take the pill, 2 cancelled their procedure, and 1 could not have cystoscopy due to urethral stricture). Of the 5 patients who qualified for this phase of the study, the mean time from medication to cystoscopy was 153 minutes (range 17-304 minutes). At the time of cystoscopy, 2 patients had grade 3 urine (Fig. 1), 2 had grade 2 and 1 had grade 0.
Phase 2
Twenty-three patients were enrolled in phase 2. One patient was
Discussion
Our study confirms that phenazopyridine successfully colors the urine orange, and as a result can aid in visualization of the UOs. When performing office flexible cystoscopy, it is difficult to drain and irrigate the bladder, and as a result, the bladder mucosa was obscured in patients enrolled in phase 1 (Fig. 1). Although we had to abandon this method, 1 takeaway from this phase of the study was that the medication can be effective in as little as 17 minutes. This is in contrast to Cohen
Conclusion
Phenazopyridine can be used to identify UOs at the time of urologic endoscopic procedures. It may be administered as early as the evening before the procedure with good effect lasting up to 18 hours. It is safe, effective, readily available, and easy to administer, and should be a tool in all urologists' armamentarium.
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Comparison of times to ureteral efflux after administration of sodium fluorescein and phenazopyridine
J Urol
(2017) Methylene blue
Methylene Blue and the risk of serotonin toxicity
Cited by (0)
Financial Disclosure: The authors declare that they have no relevant financial interests.