Oral Riboflavin to Assess Ureteral Patency During Cystoscopy: A Randomized Clinical Trial.

Area of Science:

• Urology
• Gynecologic Surgery
• Pharmacology

Background:

• Ureteric patency assessment is crucial during gynecologic surgery.
• Cystoscopy is a common procedure for evaluating ureteric patency.
• Identifying ureteric jets can be challenging, impacting procedural outcomes.

Purpose of the Study:

• To evaluate oral riboflavin as a marker for ureteric patency during cystoscopy.
• To compare the effectiveness of riboflavin versus placebo in visualizing ureteric jets.
• To assess the impact of riboflavin on the ease of identifying ureteric jets.

Main Methods:

• Randomized controlled trial involving patients undergoing gynecologic surgery with planned cystoscopy.
• Participants received either oral riboflavin (400 mg) or placebo the night before surgery.
• Surgeons assessed urine coloration and ease of ureteric jet visualization using standardized scales during cystoscopy.

Main Results:

• Riboflavin significantly increased urine yellow coloration compared to placebo (median 2 vs 1; P<.001).
• Ureteric jets were more easily visualized in the riboflavin group (median 5 vs 4; P<.013).
• No significant difference in confirmed bilateral ureteral patency between groups (91% vs 85%; P=.71).

Conclusions:

• Oral riboflavin administration improves the visualization of ureteric jets during cystoscopy.
• The yellow coloration induced by riboflavin aids in identifying ureteral jets.
• Riboflavin is a potentially valuable adjunct for assessing ureteric patency in gynecologic procedures.