The Journal of urology
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The Journal of urology · May 1995
Treatment of renal colic by desmopressin intranasal spray and diclofenac sodium.
The vasopressin analogue, 1-desamino-8-arginine vasopressin (desmopressin), is a potent antidiuretic without the pressor effects of vasopressin. A total of 18 patients with acute renal colic due to stone disease received 40 microgramsf1p4mopressin intranasal spray with encouraging results. There was a significant decrease in the colic pain intensity from an initial mean visual analogue score of 67 +/- 17 mm. to 39 +/- 36 mm. within 30 minutes (p < 0.001). ⋯ We conclude that intranasal desmopressin spray can be used successfully in the treatment of renal colic. It may also replace prostaglandin synthetase inhibitors in treating renal colic with the advantage of avoiding the potential side effects. Further studies are needed to investigate whether the combination of desmopressin with analgesics or spasmolytic drugs offers competitive results compared with those achieved by prostaglandin synthetase inhibitors in the treatment of renal colic.
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The Journal of urology · Feb 1995
Clean intermittent catheterization in spinal cord injury patients: long-term followup of a hydrophilic low friction technique.
Clean intermittent self-catheterization is an established option in bladder management of spinal cord injury patients. Several early and a small number of long-term studies have reported good preventive or therapeutic effects on hydronephrosis, vesicourethral reflux, urinary tract infection and incontinence. Most reports describe the use of small catheters and liberal use of jelly but urethral complications, such as strictures and false passages, seem to increase with the length of followup. ⋯ The study indicates that patients who use hydrophilic low friction low friction catheters do as well as or better than patients using conventional catheters. Above all, there is no increase in severe urethral complications with time after injury. Progression towards strictures after early urethral trauma seems to be preventable by the use of this catheter.
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Surgical procedures in children are usually performed with the patient under general anesthesia. For circumcision and additional dorsal penile nerve block is used for postoperative analgesia. We retrospectively evaluated dorsal penile nerve block as the only analgesic technique for the relief of intraoperative pain in children undergoing circumcision. ⋯ During the recovery period, only children from the general anesthesia group suffered from nausea and vomiting (9), and pain, agitation and fear (6 boys 3 to 6 years old). Average recovery room time was 38.7 +/- 7.4 minutes (range 30 to 60) in children with dorsal penile nerve block alone and 95 +/- 9.8 minutes (range 85 to 120) in those with additional general anesthesia (p < 0.001). We conclude that dorsal penile nerve block alone provides good intraoperative analgesia for circumcision in children, particularly those older than 6 years.
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The Journal of urology · Jan 1995
Clinical TrialIntraoperative irrigation with bupivacaine for analgesia after orchiopexy and herniorrhaphy in children.
Effective postoperative analgesia is important, especially in pediatric surgery. The efficacy of intraoperative surgical wound irrigation with bupivacaine for postoperative analgesia was investigated in 90 children undergoing elective inguinoscrotal surgery. ⋯ Bupivacaine irrigation was simple and complication-free. We believe that the irrigation of surgical wounds with bupivacaine should be a routine procedure in elective inguinoscrotal surgery in children.