Ureteric bupivicaine infusion for loin pain haematuria syndrome

• Published in: Annals of the Royal College of Surgeons of England Vol. 92; no. 2; pp. 139 - 141
• Main Authors: Ahmed, M, Acher, P, Deane, A M
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.03.2010; The Royal College of Surgeons of England
• Subjects: Adult; Aged; Aged, 80 and over; Anesthetics, Local - administration & dosage; Bupivacaine - administration & dosage; Cystoscopy; Female; Females; Follow-Up Studies; Hematuria - drug therapy; Hemodialysis; Humans; Infusions, Parenteral; Male; Middle Aged; Narcotics; Pain; Pain, Intractable - drug therapy; Patient Satisfaction; Patients; Syndrome; Treatment Outcome; Ureter; Urology; United Kingdom > UK
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588410X12628812458338

Loin pain haematuria syndrome is a common problem with complications including opiate dependence. Morbidity treatments include intra-ureteric capsaicin infusion, nephrectomy, autotransplantation and nephrolysis. We explored the use of flexible cystoscopic infusion of intra-ureteric bupivicaine. Patients presenting with chronic loin pain underwent urological and nephrological evaluation. Bupivicaine (0.5%, 20 ml) was infused via an intra-ureteric catheter under flexible cystoscopic guidance. Repeat infusions were offered if indicated. Sixteen of 17 patients with 1-year follow-up responded and were satisfied. Twelve of these required repeat infusions (mean, 2.9 infusions). The procedures were well tolerated by all patients without adverse effects. Intra-ureteric bupivicaine infusion has a place in the management of patients with chronic renal pain. It offers a minimally invasive alternative to other treatments. This procedure warrants further investigation within a randomised, controlled trial setting.