Evaluation of the Effects of Desmopressin in Acute Ureteral Obstruction

Moro, U; Stefani, S. De; Crisci, Alfonso; Antoni, P De; Scott, Cathryn Anne; Selli, C.

doi:10.1159/000030346

Cited by 17 publications

(5 citation statements)

References 15 publications

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“…Desmopressin is the first line of replacement therapy in the nocturnal enuresis and central diabetes insipidus [ 7 – 9 ]. Likely the antidiuretic mechanism of desmopressin is responsible for making it effective for the treatment of renal colic [ 7 , 10 ]. Desmopressin suppresses spontaneous contractions of circular smooth muscle fibers in the renal pelvis of rabbits [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

Masoumi

Darian

Forouzan

et al. 2014

Pain Research and Treatment

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The aim of this study was to compare analgesic effect of intramuscular (IM) sodium diclofenac and intranasal desmopressin combination with IM sodium diclofenac alone in patients with acute renal colic. In this randomized double-blind clinical trial, all patients aged 18 to 55 years who were diagnosed as acute renal colic and met the inclusion and exclusion criteria were randomized into two groups to receive 40 μg intranasal desmopressin spray and 75 mg IM sodium diclofenac combination (Group A) or 75 mg IM sodium diclofenac alone (Group B). The pain score of patients was assessed using a visual analogue scale (VAS) at baseline, 15, 30, 45, and 60 minutes after administration. Of all 159 patients who were assessed for eligibility finally, the results of 120 patients were analyzed. There was no significant difference regarding age and gender between two groups. The baseline VAS score was not significantly different between two groups (P = 0.44). The Mean ± SD scores of two groups reduced 15 minutes after drug administration, but this decrease was significantly more in Group A compared with Group B (P = 0.02). This pattern continued in minutes 30, 45, and 60 of drug administration. Our results showed that desmopressin could be used as an effective adjuvant in acute renal colic pain management.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

Masoumi

Darian

Forouzan

et al. 2014

Pain Research and Treatment

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“…Administration of desmopressin also has been shown to significantly decrease ureteral pressure in obstructed rat models [50].…”

Section: Antidiuretic Hormonementioning

confidence: 99%

Urological Aspects of Management

Miller

Stoller

2011

Clinic Rev Bone Miner Metab

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Renal colic describes the acute, severe, and paroxysmal pain caused by the obstruction, distension, and resultant increase in intraluminal pressure of the urinary tract. The treatment of renal colic is aimed at relief of symptoms, facilitating urinary drainage to preserve renal function and treat infection and ultimately removal or passage of the obstructing stone. The medical management of renal colic is directed at mitigating, through pharmacologic intervention, one or more of the complex processes contributing to the clinical sequelae of obstruction including pain, nausea, vomiting, and irritative voiding symptoms. Numerous medications and combinations of medications have been employed with varying degrees of clinical success. Urgent interventions are typically directed at bypassing ureteral obstruction in order to palliate the patient until such time as definitive treatment may be accomplished or facilitate drainage to further the treatment of urinary tract infection. Timing and mode of urgent intervention are dependent on clinical factors, clinician expertise, and preference and the availability of specialized equipment. Definitive management of ureteral stones is typically performed in an elective fashion and seeks to balance the risks of intervention with the clinical benefits of the various treatment modalities. Treatment approaches vary according to clinical indications, patient preference, clinician expertise, and the availability of facilities and equipment. This section covers current supporting evidence and rationale, indications and techniques for the medical management, urgent intervention, and definitive management of acute renal colic caused by ureteral stones.

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“…Existen algunos estudios que valoran la eficacia de la desmopresina intranasal en el cólico renal agudo aduciendo su facilidad de uso, efecto muy rápido y ausencia de efectos adversos, ofreciendo una buena eficacia analgésica, tanto sola como administrada junto con diclofenac, incrementando su efecto 59,60 . Este fármaco actuaría reduciendo intensamente la presión ureteral por su potente efecto antidiurético, sin los efectos presores de la vasopresina, como se demuestra en modelos experimentales 61 . Por otro lado, favorecería la liberación de beta-endorfinas hipotalámicas, aunque esta teoría continua en discusión 62 .…”

Section: Otros Analgésicosunclassified

Cólico renal: Revisión de la literatura y evidencia científica

Esquena

Rodríguez

Sánchez-Martín

et al. 2006

Actas Urológicas Españolas

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In recent years diagnosis and treatment of acute renal colic have changed thanks to the introduction of new radiological procedures that allow with high reliability to establish obstructive cause and a better treatment. In the other hand, there are multiple clinical studies that show the most effective treatments for acute crisis. The aim of this revision is to update the diagnostic and therapeutic aspects of renal colic which were modified recently, and allowed to break some classic concepts without scientific evidence.

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Evaluation of the Effects of Desmopressin in Acute Ureteral Obstruction

Cited by 17 publications

References 15 publications

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

The Efficacy of Intranasal Desmopressin as an Adjuvant in the Acute Renal Colic Pain Management

Urological Aspects of Management

Cólico renal: Revisión de la literatura y evidencia científica

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