Pd10-02 in-Vivo Acute Ureteral Dilation Using Electromotive Drug Administration (Emda) in the Porcine Ureter

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10)1 May 2024PD10-02 IN-VIVO ACUTE URETERAL DILATION USING ELECTROMOTIVE DRUG ADMINISTRATION (EMDA) IN THE PORCINE URETER Bruce M. Gao, Seyed Hossein Hosseini Sharifi, Seyed Amiryaghoub M. Lavasani, Seyedamirvala Saadat, Yi Xi Wu, Jacob Tsai, Andrei D. Cumpanas, Zachary E. Tano, Babak Naimi, Ahmad Abdel-Aziz, Sohrab N. Ali, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Bruce M. GaoBruce M. Gao , Seyed Hossein Hosseini SharifiSeyed Hossein Hosseini Sharifi , Seyed Amiryaghoub M. LavasaniSeyed Amiryaghoub M. Lavasani , Seyedamirvala SaadatSeyedamirvala Saadat , Yi Xi WuYi Xi Wu , Jacob TsaiJacob Tsai , Andrei D. CumpanasAndrei D. Cumpanas , Zachary E. TanoZachary E. Tano , Babak NaimiBabak Naimi , Ahmad Abdel-AzizAhmad Abdel-Aziz , Sohrab N. AliSohrab N. Ali , Pengbo JiangPengbo Jiang , Roshan M. PatelRoshan M. Patel , Jaime LandmanJaime Landman , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008748.59024.cb.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral access sheath (UAS) passage is limited by baseline ureteral tone. Smooth muscle relaxants have the potential to augment ureteral distensibility; however, their impact may be muted due to the poor permeability of the urothelium. Electromotive Drug Administration (EMDA) has been used to drive a drug deep into the bladder urothelium. Accordingly, we used EMDA in the ureter with three smooth muscle relaxants to assess its impact on ureteral distensibility. METHODS: In 18 female Yorkshire pigs, baseline distensibility of both ureters was determined by passing 35 cm long, Cook Medical® urethral dilators (10 Fr to 24 Fr) in 2 Fr increments at a maximal force of 3.5 Newtons. Maximum UAS size and location reached were recorded. Flexible ureteroscopy was used to determine a post-ureteroscopic lesion scale (PULS). In each of six pigs, in one ureter, an EMDA catheter was activated while alfuzosin 10 mg, isoproterenol 1 mg, or aminophylline 500 mg each diluted in 100 ml sterile water were infused at 5 ml/min for 20 minutes. In the contralateral control ureter, the EMDA catheter was not activated and only 0.9% normal saline was infused. Ureteral distensibility was re-evaluated. Dilator progression was recorded in single units (i.e. one unit each for distal, mid, and proximal ureteral progression) and in three units for each Fr increase in dilator size (i.e. 10 Fr to 11 Fr). The differences in dilation scores between the experimental and paired control ureters was assessed using Wilcoxon signed rank test. RESULTS: Only intra-ureteral EMDA administration of alfuzosin produced a significant increase in ureteral dilation score (alfuzosin 2.33 vs control -0.33, p=0.0312). EMDA administration of isoproterenol and aminophylline did not reach statistical significance (isoproterenol 0.33 vs control -1.33, p=0.34; aminophylline 1.00 vs control -0.17, p=0.13). PULS grades were all <2. CONCLUSIONS: In the porcine ureter, EMDA administration of alfuzosin significantly increased ureteral distensibility. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e185 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Bruce M. Gao More articles by this author Seyed Hossein Hosseini Sharifi More articles by this author Seyed Amiryaghoub M. Lavasani More articles by this author Seyedamirvala Saadat More articles by this author Yi Xi Wu More articles by this author Jacob Tsai More articles by this author Andrei D. Cumpanas More articles by this author Zachary E. Tano More articles by this author Babak Naimi More articles by this author Ahmad Abdel-Aziz More articles by this author Sohrab N. Ali More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...