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Sublingual desmopressin is efficient and safe in the therapy of lithiasic renal colic

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the effects of newer sublingual desmopressin administration in lithiasic renal colic, alone or combined with a nonsteroidal anti-inflammatory drug (NSAID).

Methods

Prospective single-blind study including an initial number of 249 patients with lithiasic renal colic was randomized as follows: group NSAID (71 patients) received ketorolac tromethamine (ketorolac) 30 mg im and sublingual placebo (vitamin C), groups D1 and D2 (57 and 62 patients) received sublingual desmopressin (Minirin Melt), 60 and 120 μg, respectively, whereas group C (59 patients) received a combination of 30 mg im ketorolac and 60 μg sublingual desmopressin. Pain intensity was assessed using the visual analogue scale before and thirty minutes after drug administration. Patients experiencing pain aggravation were rescued and excluded from the study.

Results

Dropout incidence was higher in the NSAID group than in the groups treated with desmopressin in monotherapy or combined with ketorolac (p < 0.05). Pain intensity was diminished at least as potently by the monotherapy with desmopressin and ketorolac. The higher dose of desmopressin and the combination therapy decreased pain intensity with 56 and 59 %, respectively, significantly more than the 47 % decrease obtained with ketorolac alone (p < 0.05 and p < 0.001). Mean pain decrease was higher in the combination group (C) than in the NSAID or D1 groups (p < 0.001 and p < 0.05, respectively), suggesting drug additivity. Patients did not experience severe side effects.

Conclusions

Sublingual desmopressin is at least as potent as NSAID in the treatment of lithiasic renal colic. The combination of sublingual desmopressin and NSAID has additive analgesic effects.

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Authors and Affiliations

  1. Department of Urology, “Gr. T. Popa” University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania

    Catalin Pricop

  2. Department of Endocrinology, “Gr. T. Popa” University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania

    Dumitru D. Branisteanu

  3. Department of Urology, Tg. Mures University of Medicine and Pharmacy, 38th Gheorghe Marinescu St, 540139, Tg Mures, Romania

    Martha Orsolya

  4. Department of Urology, “C.I. Parhon” Clinical Hospital, 50th Carol Bd., 700503, Iasi, Romania

    Dragos Puia

  5. Department of Endocrinology, “St. Spiridon” Emergency Hospital, 1st Independentei Bd., 700106, Iasi, Romania

    Anca Matei

  6. Department of Nephrology and Dialysis, Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37th Dionisie Lupu St, Sector 1, 020022, Bucharest, Romania

    Ionel Alexandru Checherita

Authors
  1. Catalin Pricop
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  2. Dumitru D. Branisteanu
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  3. Martha Orsolya
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Corresponding author

Correspondence to Martha Orsolya.

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Conflict of interest

All authors (Cătălin Pricop, Dumitru D. Brănișteanu, Martha Orsolya, Dragoș Puia, Anca Matei and Ionel Alexandru Checheriță) declare that they have no conflict of interest.

Human and animal rights

All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional committees of the two involved universities and with the 1964 Declaration of Helsinki and its later amendments. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Pricop, C., Branisteanu, D.D., Orsolya, M. et al. Sublingual desmopressin is efficient and safe in the therapy of lithiasic renal colic. Int Urol Nephrol 48, 183–189 (2016). https://doi.org/10.1007/s11255-015-1173-z

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  • DOI: https://doi.org/10.1007/s11255-015-1173-z

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