Clinical application of antispasmodic drugs in ureteroscopic lithotripsy

Abstract

Objective To explore clinical value of preoperative use of ureteral antispasmodic drugs in ureteroscopy lithotripsy.Methods 252 patients with ureteral calculus were randomly divided into five groups:Group A with 50 patients,as the control group; Group B,51 patients,were treated with Phloroglucinol (80 mg,ivgtt,once daily); Group C,50 patients,were treated with tamsulosin (0.4 mg,po,once daily),Group D,49 patients,were treated with 654-2 (10 mg,ivgtt,twice daily); Group E,52 patients,were treated with progesterone (40 mg,im,once daily).All groups were given anti-inflammatory treatment preoperatively.8.0/9.8 F rigid ureteroscope was used for ureteroscopic lithotomy or lithotripsy 3 days after antispasmodic treatment.Results The operation was successful in all cases.The overall stone-free rate was 98.8％(249/252).In the operation,there was statistical difference in using reteroscope under direct vision between group A and E (P ＜ 0.05).There were statistical differences in postoperative complication incidence between group A and B,C,D,E (P ＜ 0.05).After 3-18 months' (average 9 months) follow-up period,there was no recurrence and no ureterostenosis was found.Conclusions Routine preoperative use of antispasmodic drugs can relax ureteral smooth muscle,make the ureter relaxed and diastolic,and significantly lower the incidence of intraoperative ureteral injuries.The antispasmodic effect of progesterone is the best among several antispasmodic drugs,with few side effects. Key words: Anticonvulsive drug; Ureteral injury; Ureteroscope