| The role of mucoregulatory agents after continence-preserving urinary diversion surgery. | |
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MedLine Citation:
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PMID: 22382478 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Purpose The postsurgical use of N-acetylcysteine, octreotide, and other agents to reduce mucus accumulation after urinary diversion procedures is described. Summary Patients undergoing continence-sparing bladder resection are at risk for infection and stone formation due to mucus accumulation. In addition to N-acetylcysteine, agents studied for mucoregulatory control in such patients include aspirin, urea, ranitidine, and octreotide. N-acetylcysteine has high mucolytic activity in vitro, and positive outcomes with instillations of 20% N-acetylcysteine solution have been reported in some patients. Significant mucus reductions were reported in small numbers of patients treated with oral ranitidine 300 mg daily or instillations of 30 mL of urea 40% solution, while the benefits of aspirin are more questionable. To date, there has been only one randomized controlled trial comparing various agents for mucus reduction after reconstructive bladder surgery; the results indicated no significant benefits with the use of N-acetylcysteine, aspirin, or ranitidine. In one small study (n = 40), the use of subcutaneous octreotide immediately before and for 15 days after surgery was reported to yield significant reductions in mucus production, the need for bladder irrigation to clear blockages, and the mean duration of hospital stays. Conclusion Various agents evaluated for mucus control after urinary diversion procedures (oral ranitidine or aspirin, N-acetylcysteine or urea instillations, and subcutaneous octreotide), while reportedly effective for some patients, remain of questionable benefit. More research is needed to define the optimal role of these agents for this indication. |
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Authors:
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Wendy M Covert; Shannon N Westin; Pamela T Soliman; Ginger D Langley |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists Volume: 69 ISSN: 1535-2900 ISO Abbreviation: Am J Health Syst Pharm Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9503023 Medline TA: Am J Health Syst Pharm Country: United States |
Other Details:
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Languages: eng Pagination: 483-6 Citation Subset: IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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