Pharmacological Ureteral Dilation With Ýntraluminal Papaverine Administration

Prior to ureterorenoscopy procedures, dilation of ureteral orifice and intramural ureter is recommended. Cone tip metallic bougies and balloon dilators are frequently used for this purpose. In the present study, dilating effect of intraluminal papaverine administered through a Swan-Ganz catheter placed in the ureteral orifis has been studied. Twenty patients undergoing elective endourologic surgery, having normal collecting systems, were included. To the right ureter, 240 mg papaverine (8cc) + iopamidol (2cc) and to the left 8cc physiological saline + 2cc iopamidol were administered simultaneously within 5 seconds. Following the administration of radioopaque materials into both ureters, fluoroscopic ureteral diameters and intraluminal pressures were measured at zero, 5th and 10th minutes. The results were compared for diameter and pressure changes in the papaverine administered and control sides. In papaverine administered side, a statistically significant decrease in intraluminal pressure and increase in ureteral diameter at 5th and 10th minutes have been found (p<0.05). When both sides were compared the increase in diameter but not the decrease in pressure was significantly different on the papaverin administered side. During and after the procedure, there was no complication or significant change in the vital signs. Prior intraluminal administration of papaverine may facilitate ureterorenoscopy procedures and decrease the complication rates by dilating the ureter. Keywords: Ureter, Papaverin, Dilatation