Relaxant Effect of Thiphenamil HCI on Upper Urinary Tract Frequency of Contraction of Healthy Asymptomatic Volunteers

Abstract

The pharmacologic effect of thiphenamil HCI on the upper urinary tract as a relaxant of renal pelvic contractions was studied. A total of 17 subjects with no known upper urinary tract abnormalities were scanned. A Diasonics ultrasound scanner at 3.5 MHz was used to visualize the kidney and renal pelvis with the subject in the supine position. Control recordings of renal pelvic and calyceal contractility were made on videotape for approximately 30 min. The subject was then given a single dose of 400 mg thiphenamil HCI and visualization of contractility continued for approximately 60-90 min. Criteria for the evaluation of the data were the mean frequency of pelvic contraction cross-section of the pelvis, and velocity and direction contraction. Ultrasonic images were filtered by a video filtering process and averaged using the digital conversion and summation in real time. The results show that under control conditions renal pelvic contractions are at a frequency of 2 ± 1.8 min-1. Contractions are initiated with the intrarenal pelvis and continue towards the ureter at a rate of 1.3 ± 0.8 cm/s. Following thiphenamil HCI, there is a significant reduction in pelvic contraction frequency, 0.6 ± 0.6 ∏ikr’, and the opposing walls of the renal pelvis do not completely close in the formation of a bolus. The results obtained from this study demonstrate that thiphenamil suppresses upper urinary tract contractility. As a consequence of this observation, it is postulated that this agent may be of use in the acute relaxation of the upper urinary tract for renal colic and stone management.

Pharmacologic Effect of Thiphenamil HCI on Lower Urinary Tract Function of Healthy Asymptomatic Volunteers

“…In this paper, we present the results of a urodynamic study specifically designed to study the pharmacologic action of thiphenamil HC1 (United Pharmaceuticals) in normal, young, asymptomatic female volunteers. This agent, (3-diethylaminoethyldiphenylthioacetate, is unusual in that it is the ester of a thioacid and was introduced as a syn thetic antispasmotic [1,2], In recent years, it has been evaluated for its action in relaxing the ureter to facilitate stone passage [3], Incidental observations during upper urinary tract trials have shown that thiphenamil HC1 pro duced a decrease in urgency incontinence and frequency in some subjects. Preliminary evaluations of this agent in patients with detrusor instability indicate that thiphen amil HC1 significantly ameliorate the symptoms of detru sor-originated incontinence [4], A urodynamic study pro tocol was designed to distinguish between detrusor con tractility during voiding and isometric contractility dur ing bladder filling.…”