title: The role of preoperative oral vitamin B in the cystoscopic assessment of ureteric patency.
abstract: OBJECTIVE
  The objective of this study is to determine whether oral vitamin B can be used as a marker of ureteric patency at cystoscopy, and thereby reduce the need for intraoperative intravenous indigo carmine.
  
  
  METHODS
  Patients scheduled for cystoscopy, or for an operation likely to require a cystoscopy, were given three tablets of vitamin B complex orally 1-4 h prior to their operation. The time of administration, time of operation, and time of cystoscopy were recorded. The time taken for ureteric jets to be visualized was also recorded. The color of the urine was graded by the operator as being clear (negative) or bright yellow (positive), indicating ureteric patency and that no indigo carmine was required.
  
  
  RESULTS
  Sixty-nine women in total were given vitamin B prior to their cystoscopy. One case was cancelled because of presumed but unproven aspiration. In 49 of the remaining 68 cases (72.1%), yellow urine was seen at both ureteric orifices. In 19 (27.9%) cases, yellow urine was not seen at both ureteric orifices; however, unilateral yellow, clear, or turbulent jets were seen in all but one case. The mean time from dose to cystoscopy was 162 min and the mean time for visualization of both ureteric jets was 2.2 min with no significant difference between groups. Indigo carmine was used in only two cases (2.9%).
  
  
  CONCLUSIONS
  The results of this study show that oral vitamin B administration preoperatively has the potential to be used to reduce the requirement for intravenous indigo carmine administration. This would have advantages in reducing the cost and toxicity of intravenous indigo carmine administration. Vitamin B warrants further investigation and refinement as a marker of ureteric patency at cystoscopy.
authors.affiliation: Southern Health, Department of Obstetrics and Gynaecology, Melbourne, Australia. shavif@hotmail.com
authors.forename: Shavi
authors.initials: S
authors.lastname: Fernando
authors.forename: Caroline
authors.initials: C
authors.lastname: Dowling
authors.forename: Anna
authors.initials: A
authors.lastname: Rosamilia
mesh_terms: D000284:Administration, Oral; D015415:Biomarkers / Q000652:urine; D003558:Cystoscopy; D005260:Female; D006801:Humans; D011300:Preoperative Care; D013997:Time Factors; D014513:Ureter / Q000502:physiology*; D014803:Vitamin B Complex / Q000008:administration & dosage* / Q000652:urine*
chemical_list: D015415:Biomarkers; D014803:Vitamin B Complex