Ureteric bupivicaine infusion for loin pain haematuria syndrome.
BACKGROUND
Loin pain haematuria syndrome is a common problem with complications including opiate dependence. Morbidity treatments include intra-ureteric capsaicin infusion, nephrectomy, autotransplantation and nephrolysis. We explored the use of flexible cystoscopic infusion of intra-ureteric bupivicaine.


METHODS
Patients presenting with chronic loin pain underwent urological and nephrological evaluation. Bupivicaine (0.5%, 20 ml) was infused via an intra-ureteric catheter under flexible cystoscopic guidance. Repeat infusions were offered if indicated.


RESULTS
Sixteen of 17 patients with 1-year follow-up responded and were satisfied. Twelve of these required repeat infusions (mean, 2.9 infusions). The procedures were well tolerated by all patients without adverse effects.


CONCLUSIONS
Intra-ureteric bupivicaine infusion has a place in the management of patients with chronic renal pain. It offers a minimally invasive alternative to other treatments. This procedure warrants further investigation within a randomised, controlled trial setting.
Ahmed
M
M
Department of Urology, Kent and Canterbury Hospital, Canterbury, UK. muneer_ahmed@hotmail.co.uk
Acher
P
P
Deane
A M
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D003558:Cystoscopy; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000188:drug therapy*; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D013577:Syndrome; D016896:Treatment Outcome; D014513:Ureter
D000779:Anesthetics, Local; D002045:Bupivacaine