Confirmation of ureteric patency during cystoscopy using phenazopyridine HCl: a low-cost approach.
OBJECTIVE
To describe the use of oral phenazopyridine (Pyridium) prior to pelvic surgery to facilitate intraoperative confirmation of ureteric patency.


METHODS
We performed a chart review of women given phenazopyridine preoperatively prior to pelvic surgery in a tertiary care centre between July 2004 and June 2005. The primary outcome was the cystoscopic observation of bilateral ureteric urine efflux. Secondary outcomes included the visualization of bladder mucosa during cystoscopy, postoperative complications, and urinary tract injury diagnosed postoperatively (i.e., missed intraoperatively).


RESULTS
Pelvic reconstructive surgery requiring intraoperative cystoscopy was performed in 124 women. Bilateral ureteric patency and bladder mucosal integrity was confirmed in all cases. Phenazopyridine was well tolerated by all patients, and its use was unequivocally documented in 32 subjects whose chart was reviewed to determine postoperative course. Bladder mucosal appearance was unaltered. Dye continued to be excreted during prolonged procedures. Postoperatively, no ureteric injuries were subsequently diagnosed in any patients. The cost per patient of phenazopyridine ($0.29) is substantially lower than indigo carmine ($34.50).


CONCLUSIONS
Preoperative oral phenazopyridine is an inexpensive and safe dye that assists effectively in the confirmation of ureteric patency when cystoscopy is planned during pelvic surgery.
Hui
Jane Y C
JYC
Division of Urogynaecology, Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
Harvey
Marie-Andrée
MA
Division of Urogynaecology, Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
Johnston
Shawna L
SL
Division of Urogynaecology, Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
D004396:Coloring Agents / Q000191:economics; D003558:Cystoscopy; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008875:Middle Aged; D010621:Phenazopyridine / Q000191:economics; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D013520:Urologic Surgical Procedures; D055988:Uterine Artery; D014654:Vascular Patency
D004396:Coloring Agents; D010621:Phenazopyridine