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Use of 50% Dextrose as the Distension Medium During Cystoscopy for Visualization of Ureteric Jets

Narasimhulu, Deepa M. MD; Prabakar, Cheruba MD; Tang, Nancy MD; Bral, Pedram MD

doi: 10.1097/AOG.0000000000001182
Contents: Procedures and Instruments
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BACKGROUND: Indigotindisulfonate sodium has been used to color the urine and thereby improve the visualization of ureteric jets during intraoperative cystoscopy. After indigotindisulfonate sodium became unavailable, there has been an ongoing search for an alternate agent to improve visualization of the jets.

METHOD: We used 50% dextrose, which is more viscous than urine, as the distension medium during cystoscopy so that the ureteric efflux is seen as a jet of contrasting viscosity. We instilled 100 mL of 50% dextrose into the bladder through an indwelling catheter, which is then removed and cystoscopy is performed as usual.

EXPERIENCE: We observed jets of contrasting viscosity in every patient in whom 50% dextrose was used as compared with coloring agents in which the jet is not always colored at the time of cystoscopy. Visualization of the other structures in the bladder and the bladder wall itself is not altered by 50% dextrose, although the volume of 50% dextrose that we typically use may not provide adequate distension for a complete assessment of the bladder. If additional distension is necessary, normal saline may be used in addition to the 50% dextrose once the ureteric jets have been assessed.

CONCLUSION: Fifty percent dextrose is an effective alternative to indigotindisulfonate sodium for visualization of ureteric jets during cystoscopy.

Fifty percent dextrose is an effective alternative to indigotindisulfonate sodium for visualization of ureteric jets during cystoscopy.

Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.

Corresponding author: Deepa M. Narasimhulu, MD, 967, 48th Street, Brooklyn, NY 11219; e-mail: dnarasimhulu@maimonidesmed.org.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented at the 44th American Association of Gynecologic Laparoscopists Global Congress on Minimally Invasive Gynecology, November 15–19, 2015, Las Vegas, Nevada.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.