Document Detail


Effect of smooth muscle relaxant drugs on proximal human ureteric activity in vivo: a pilot study.
MedLine Citation:
PMID:  17530238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Drugs are increasingly being used to promote stone passage in renal colic. Diclofenac, nifedipine and tamsulosin cause ureteric smooth muscle relaxation in vitro; however, in clinical trials nifedipine and tamsulosin promote stone passage whereas diclofenac has no apparent benefit. We adapted a ureteric pressure transducer catheter in an attempt to compare the human ureteric response to these drugs in vivo. The catheter was inserted into the contralateral ureter following ureteroscopy for stone disease. Contraction frequency, pressure and velocity measurements were recorded at 24 h. Each patient was randomly allocated to receive oral diclofenac, nifedipine or tamsulosin. Measurements were taken following drug administration. Eighteen patients (mean age 50 years) were recruited. Two patients were excluded intraoperatively and three required early removal of the catheter. Prior to drug administration, the mean number of contractions recorded was 0-4.1/min and the peak contraction pressure ranged from 11 to 35 mmHg. Conduction velocity ranged from 1.5 to 2.6 cm/s. Ureteric peristalsis persisted in all patients despite these drugs. Diclofenac and nifedipine produced inconsistent ureteric pressure responses but had little effect on contraction frequency. Tamsulosin significantly reduced ureteric pressure but had no effect on contraction frequency. There are many limitations associated with the use of ureteric catheters, however, they may provide some useful information when used to record the response to an intervention in the same patient. These preliminary results suggest a reduction in pressure generation may be the essential factor in the promotion of stone passage. More work is required but these drugs may work by preventing the increased, uncoordinated muscular activity seen in renal colic whilst maintaining peristalsis, thereby promoting stone passage.
Authors:
Kim Davenport; Anthony G Timoney; Francis X Keeley
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Publication Detail:
Type:  Journal Article     Date:  2007-05-26
Journal Detail:
Title:  Urological research     Volume:  35     ISSN:  0300-5623     ISO Abbreviation:  Urol. Res.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-24     Completed Date:  2008-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364311     Medline TA:  Urol Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  207-13     Citation Subset:  IM    
Affiliation:
Bristol Urological Institute, Westbury-on-Trym, Bristol, UK. DrKimDav@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Antagonists / pharmacology,  therapeutic use
Adult
Cyclooxygenase Inhibitors / pharmacology,  therapeutic use
Diclofenac / pharmacology,  therapeutic use
Female
Humans
Male
Middle Aged
Muscle, Smooth / drug effects*
Nifedipine / pharmacology,  therapeutic use
Parasympatholytics / pharmacology*,  therapeutic use
Pilot Projects
Sulfonamides / pharmacology,  therapeutic use
Tocolytic Agents / pharmacology,  therapeutic use
Transducers, Pressure
Ureter / drug effects*
Urinary Catheterization / methods*
Urolithiasis / drug therapy
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Antagonists; 0/Cyclooxygenase Inhibitors; 0/Parasympatholytics; 0/Sulfonamides; 0/Tocolytic Agents; 106133-20-4/tamsulosin; 15307-86-5/Diclofenac; 21829-25-4/Nifedipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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