Desmopressin as an alternative solution for urinary leakage after ureterocaliceal surgeries.
BACKGROUND
Persistent urine leakage is common following iatrogenic urinary collecting system injuries. Management of a urine leak usually includes manipulations such as catheter drainage, ureteral stenting, and percutaneous nephrostomy placement. The aim of this study was investigation the potential beneficial effect of desmopressin in reduction of urinary leakage duration.


METHODS
Fifteen patients with incisional urinary leakage were enrolled in this study. They had undergone pyeloplasty (n = 9), pyelolithotomy (n = 4), and ureterocaliceal anastomosis (n = 1). All of them had ureteral stenting or nephrostomy catheters, and urinary leakage had lasted for at least 15 days. Seven patients received desmopressin spray, 1 puff, twice a day, from the 16th days of urinary leakage, and 8 patients (control group) did not receive any medical treatment. The duration of urinary leakage was compared between the two groups.


RESULTS
The patients were 5 women and 10 men with the median age of 37 years (range, 26 to 58 years). None of the patients had urinary obstruction. There were no significant differences in age and sex distribution between the two groups. The mean urinary leakage duration was 28.7 +/- 7.2 days in the patients of desmopressin group and 47.7 +/- 8.8 days in those of the control group (P = .04).


CONCLUSIONS
Our study showed that desmopressin can reduce the duration of incisional urinary leakage. We conclude that patients with prolonged urinary leakage after pyelocaliceal surgery who does not respond to surgical urinary drainage may benefit from desmopressin.
Razzaghi
Mohammad Reza
MR
Department of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rezaei
Alireza
A
Javanmard
Babak
B
Lotfi
Behzad
B
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D016022:Case-Control Studies; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery; D014546:Urinary Catheterization / Q000009:adverse effects; D014548:Urinary Fistula / Q000188:drug therapy* / Q000209:etiology
D006490:Hemostatics; D003894:Deamino Arginine Vasopressin