Use of Phenazopyridine in Visualizing Ureteral Jet Stream During Cystoscopy [28A

Abstract

INTRODUCTION: Cystoscopy is an important for evaluation of potential lower urinary tract injuries including urethral and bladder injury following gynecologic surgery. In such times when evaluation of the lower urinary tract is indicated; previously, patients were previously given indigo carmine to assist in the evaluation of ureteral jet flow. There is a void in safe, available options to assist with evaluation of the ureteral jet flow. The use of phenazopyridine could be an alternative. METHODS: Patients reviewed from the Sacred Heart Hospital Medical Oncology Group in Pensacola, Florida from October 1, 2014 to March 31, 2015. Patients were included in this study if the operative report indicated that cystoscopy was performed with documented oral phenazopyridine 200 mg given. The primary outcome was to identify if phenazopyridine aided in identifying the ureteral jet stream. RESULTS: A total of 241 patients had surgery. Of the 241 charts reviewed, 112 patients had cystoscopy performed with administration of phenazopyridine and documentation of cystoscopy findings. Phenazopyridine-stained urine with bilateral ureteral efflux was documented in 94 charts. Bilateral ureteral efflux without mention of phenazopyridine-stained urine was documented in 11%. In 6 charts, phenazopyridine was given preoperatively but was specified as not being seen. CONCLUSION: Studies have shown that routine use of cystoscopy in gynecologic surgeries can improve earlier detection of lower urinary tract injuries, which can prevent morbidity and long-term sequelae. It's more reliable in diagnosis of acute ureteral obstruction. The use of phenazopyridine is both safe and useful for visualization of the ureteral jet streams during intra-operative cystoscopy.