Assessing Ureteral Patency Using D50 as a Visualization Medium in Cystoscopy Our objective is to demonstrate an inexpensive and readily available alternative to indigo carmine to visualize ureteral patency using 50 mL of 50% dextrose instilled intraoperatively in the bladder during cystoscopy. D50 is an inexpensive agent readily available in all operating rooms and crash carts. The cost for a single administration of 50 mL of D50 is less than $3 at our institution. When backfilled through the cystoscope using a syringe attached to the lower lock of the cystoscope sheath, the bladder distension fluid becomes viscous, allowing for easy visualization of efflux from the ureters. An additional benefit of using D50 is that there is no requirement for preoperative administration of oral agents such as phenazopyridine or vitamin B, and there is no need to wait for renal clearance of intravenous administered agents such as methylene blue or sodium fluorescein. In conclusion, D50 is an effective, inexpensive, and readily available alternative to indigo carmine for visualization of ureteral patency during intraoperative cystoscopy that does not require intravenous or preoperative oral administration. A prospective study to determine the side effect profile is recommended.

visualizing ureteral patency

cystoscopy

D50

alternative method

urine flow