Evaluation of Fluorescein Use During Cystoscopy

Study Overview
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Brief Summary
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This study is a prospective randomized controlled study. Female patients over 18 years of age, who present for treatment of pelvic organ prolapse and/or stress urinary incontinence at the Pelvic Floor Center at the Johns Hopkins Bayview Medical Center, and who consent to undergo a urogynecologic surgical procedure, will be considered for inclusion in the study. Their histories will be reviewed by their attending surgeon and if they meet inclusion and exclusion criteria, they will be recruited for participation. The primary investigator and co-investigators (attending physician, fellows) will determine patient eligibility. Regarding privacy issues, the patients will be consented for both the procedure and for the study with careful attention made to emphasize patient confidentiality. When the patient presents for surgery, they will be randomized to receive either preoperative pyridium or intraoperative fluorescein or no dye. Given the color differences between the dyes, blinding will not occur. The process for recruitment will be consistent and any deviations from the protocol will be reported to the Johns Hopkins Internal Review Board.

Official Title
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Evaluation of Fluorescein Use During Cystoscopy, a Randomized Control Trial

Conditions
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Intraoperative Cystoscopy

Intervention / Treatment
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* Drug: Phenazopyridine
* Drug: Fluorescein


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • English speaking, female patients, ages 18 and older, undergoing urogynecologic surgery for pelvic organ prolapse or urinary incontinence with a planned concomitant cystoscopy at Johns Hopkins Bayview Exclusion Criteria: Non-English speaking, Known allergic reactions or sensitivities to sodium fluorescein or phenazopyridine Known glucose-6-phosphate dehydrogenase or nicotinamide adenine dinucleotide- methemoglobin reductase deficiency Pregnant or breastfeeding Known renal disease or renal failure Undergoing concomitant non-urogynecologic procedures Dementia or cognitive impairment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: No dye<br>Participants will not receive a preoperative or intraoperative dye prior to their intraoperative concomitant cystoscopy. | |
| Active Comparator: Phenazopyridine<br>Participants will receive a single 200mg oral dose of phenazopyridine with a sip of water 30 minutes prior to their surgery which involves an intraoperative concomitant cystoscopy. | Drug: Phenazopyridine<br> <br> * Other names: Pyridium;|
| Active Comparator: Fluorescein<br>Participants will receive 0.25cc of 10% intravenous sodium fluorescein administered by anesthesia during their surgery, immediately prior to their intraoperative concomitant cystoscopy. | Drug: Fluorescein<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time required to complete cystoscopy | The attending surgeon of each case will document the time required to complete the cystoscopic assessment. | 30 min | 
| Time required to visualize ureteral jets | The attending surgeon of each case will document the time required to visualize the right and left ureters. | 30 min |