Comparison of Times to Ureteral Efflux after Administration of Sodium Fluorescein and Phenazopyridine

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• 作者：Seth A. Cohen ; Zaid Chaudhry ; Janine L. Oliver ; Evgeniy I. Kreydin ; My-Linh T. Nguyen ; Steven A. Mills ; A. Lenore Ackerman ; Ja-Hong Kim ; Christopher M. Tarnay ; Shlomo Raz ; ^{sraz@mednet.ucla.edu}
• 关键词：ureter ; reconstructive surgical procedures ; urination ; fluorescein ; phenazopyridine
• 刊名：The Journal of Urology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：197
• 期：2
• 页码：519-523
• 全文大小：1030 K
• 卷排序：197

文摘

There is currently a national shortage of indigo carmine. In efforts to identify the most efficient aid for visualizing ureteral efflux intraoperatively we investigated the time to excretion of phenazopyridine vs a newly identified alternative, sodium fluorescein.Materials and MethodsWe analyzed prospectively collected data on a cohort of women who underwent pelvic reconstructive surgery in 2015. Per provider preference patterns a number of patients were administered 200 mg phenazopyridine orally with a sip of water 1 hour prior to the start of operative time. Other patients were given 0.5 ml 10% sodium fluorescein intravenously in the operating room. In all cases time was measured between the administration of the agent and the visualization of color changes consistent with agent efflux in an indwelling catheter, which was placed at the start of the operation. Differences in excretion times between the groups were compared with the Wilcoxon rank sum test.ResultsSeven women received phenazopyridine and 5 received sodium fluorescein. Mean excretion time was significantly longer in the phenazopyridine group compared to the sodium fluorescein group (81.9 vs 5.1 minutes, p = 0.0057). Median excretion time for phenazopyridine was 70 minutes (range 59 to 127) and for sodium fluorescein it was 5 minutes (range 3 to 9).ConclusionsSodium fluorescein is excreted significantly faster in the operating room compared to phenazopyridine. Depending on the cost of these agents at an institution, in addition to the desire to decrease operative time, this may impact practice patterns and agent selection.