The Effects of Local Administration of Aminophylline on Transureteral Lithotripsy

Abstract

Introduction. Urinary stone is a common cause of urinary tract disease. Stone excretion using ureteroscope is effective in inferior ureter. The aim of this study was to investigate the effects of aminophylline on ureteral spasm during ureteroscopy in acute phase of renal colic. Methods. In this double-blind randomized clinical trial, 120 patients with ureteral stones were enrolled and randomized into two groups. The bladder was drained and then received a 150 mL irrigation solution. Irrigation solution was saline and saline plus 10 mL aminophylline at 250 mg dose for control and case groups, respectively. Ureteroscopy and transureteral lithotripsy (TUL) were performed five minutes after irrigation. Results. The mean duration of TUL was 4.2 ± 2.61 min and 8.4 ± 2.9 min for control and case groups, respectively. The successful rate was 95% and 76.1% in case and control groups, respectively. Further extracorporeal shock wave lithotripsy (SWL) was performed in 5% and 30% for patients in case and control groups, respectively. Conclusion. Aminophylline facilitated ureteroscopy and increased the success rate in the treatment of renal colic using TUL. No significant complications from post-TUL were observed. Using aminophylline carries several advantages such as reducing procedure duration, decreasing the need for ureteral and double-J catheter, and reducing stone migration to the kidney and use of SWL.

Therapeutic Approaches for Renal Colic in the Emergency Department: A Review Article

“…In their study using a local injection of aminophylline during trans-urethral lithotripsy, Baregarnezhad et al showed that aminophylline facilitates the uretroscopy procedure, increases the success rate for the treatment of renal colic by using (transurethral lithotripsy), decreases operative time, and reduces the need for a double J catheter and wave lithotripsy (45). …”

“…Its mechanism is through the inhibition of a non-selective phosphodiesterase inhibitor that; increases the concentration of intracellular cAMP, activates PKA (protein kinase A), inhibits TNF-α and the synthesis of leukotrienes, and reduces inflammation. Non-selective antagonism of adenosine receptors is the second mechanism ( 45 ). Aminophylline is a well-known drug and it is widely used in the treatment of renal colic ( 46 ).…”

Comparison of Local Administration of Aminophylline Versus Normal Saline on Transureteral Lithotripsy in Patients Presenting With Acute Renal Colic

“…Barzegarnezhad et al, reported that local administration of aminophylline during TUL leads to 95% success rate in interventional [9] group as compared to placebo (72%) . Mulay et al, reported that aminophylline group did not [11] show any side effects similar to our study .…”

“…Barzegarnezhad et al reported that aminophylline is associated with high success rate in renal colic patients with transureteral lithotripsy. Aminophylline leads to several benefits including decrease process duration, decrease stone migration towards kidney, [9] reduce ureteral and catheter (double J) need . Djaladat et al reported that aminophylline is an effective drug is pain relief and reduce narcotic usage.…”

“…Sample size of 90 cases; 45 cases in each group is calculated with 90% power of test, 5% level of significance and taking expected percentage of complete stone removal i.e. 95% with aminophylline and 71.6% with normal saline in patients with acute [9] renal colic . Patients were selected with consecutive, (non-probability) sampling.…”