Can Prostaglandins Facilitate the Passage of Ureteric Stone Streets?

  • R. S. Cole
  • C. H. Fry


The impetus to this study arose from the belief that an agent introduced directly into the upper urinary tract, via a percutaneous nephrostomy tube, which consistently increased the contractility of the ureteric smooth muscle may facilitate the passage of established and obstructing stone streets arising from the disintegration of urinary stones by extracorporeal shock wave lithotripsy (ESWL). At present it is difficult to predict which group of agents would fulfill the role of a ureteric inotrope.

A study has been carried out on the actions of the prostaglandins E2 and F2 alpha and their synthesis inhibitors, indomethacin and diclofenac sodium, upon isolated human ureteric smooth muscle, using the technique of microsuperfusion designed to ensure good tissue viability.

Indomethacin and diclofenac sodium were shown to abolish almost completely the contractile response of ureteric muscle to electrical field stimulation. Contractile activity, in the presence of the inhibitors, could be restored by prostaglandin E2 or F2 a1pha or increasing the external potassium concentration, [K+]o of the superfusate.

Prostaglandin E2 or F2 alpha alone was shown to dramatically increase both the phasic and tonic component of the electrically stimulated contractions, on occasions inducing spontaneous activity. A possible mechanism of action was elucidated with an electrophysiological technique using intracellular microelectrodes. The mean membrane potential recorded was 54.7 mV (SD ± 10 mV, n=15). The depolarizing action of raising [K+]o was demonstrated and prostaglandin F2 alpha (3 × 10−6M) was shown to produce a small depolarization of the ureteric muscle cell membrane.


Contractile Response Extracorporeal Shock Wave Lithotripsy Electrical Field Stimulation Nephrostomy Tube Prostaglandin Synthetase Inhibitor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Arsdalen KNV: Secondary procedures after ESWL. In Riehle RA and Newman RC (eds): Principles of Extracorporeal Shock Wave Lithotripsy. New York: Churchill Livingstone, 1987.Google Scholar
  2. 2.
    Hardy MR and McLeod DG: Silent renal obstruction with severe functional loss after extracorporeal shock wave lithotripsy: a report of two cases. J Urol 137: 91, 1987.PubMedGoogle Scholar
  3. 3.
    Weiss RM: Ureteral pharmacology. In Finkbeiner AE, Barour GL, Bissada NK (eds): Pharmacology of the Urinary Tract and Male Reproductive System. New York: AppletonCentury-Crofts, 1982.Google Scholar
  4. 4.
    Kurzrok R and Lieb CC: Biochemical studies of human semen: the action of semen on the human uterus. Proc Soc Exp Biol Med 28: 268, 1930.Google Scholar
  5. 5.
    Horton EW: Prostaglandins and smooth muscle. Brit Med Bull 35: 295, 1979.PubMedGoogle Scholar
  6. 6.
    Jeremy JY,Tsang V, Mikhailidis DP, et al: Eicosanoid synthesis by human urinary bladder mucosa: pathological implications. Br J Urol 59:36, 1987.Google Scholar
  7. 7.
    Bultitude MI, Hills NH, Shuttleworth KED: Clinical and experimental studies on the action of prostaglandins and their synthesis inhibitors on detrusor muscle in vitro and in vivo. Br J Uro148:631, 1976. 66 Shock Wave Lithotripsy II: Urinary and Biliary Google Scholar
  8. 8.
    Boyarsky S, Labay P, Gerber C: Prostaglandin inhibition of ureteral peristalsis. Invest Urol 4: 9, 1966.PubMedGoogle Scholar
  9. 9.
    Abrams PH and Feneley RCL: The actions of prostaglandins on the smooth muscle of the human urinary tract in vitro. Br J Urol 47: 909, 1976.CrossRefGoogle Scholar
  10. 10.
    Aicken CC, Brading AF, Burdyga TV: Evidence for sodium-calcium exchange in the guinea pig ureter. J Physiol 347: 411, 1984.Google Scholar
  11. 11.
    Thulesius O and Angelo-Khattar M: The effect of indomethacin on the motility of isolated sheep ureters. Acta Phartnacol Toxicol 56: 298, 1985.CrossRefGoogle Scholar
  12. 12.
    Angelo-Khattar M, Thulesius O, Nilsson T, et al: Motility of the human ureter, with special reference to indomethacin. Scand J Urol Nephrol 19: 261, 1985.PubMedCrossRefGoogle Scholar
  13. 13.
    Al-Ugaily L, Thulesius O, Angelo-Khattar M: New evidence for prostaglandin induced motility of the ureter. Scand J Urol Nephrol 20: 225, 1986.PubMedCrossRefGoogle Scholar
  14. 14.
    Cole RS, Palfrey ELH, Smith SE, et al: Indomethacin as prophylaxis against ureteric colic following extracorporeal shock wave lithotripsy. J Urol 141: 9, 1989.PubMedGoogle Scholar
  15. 15.
    Wooster MJ: Effects of prostaglandin E1 on dog ureter in vitro. J Physiol 213: 51P, 1970.Google Scholar
  16. 16.
    Kuriyama T, Osa T, Toida N: Membrane properties of the smooth muscle of guinea pig ureter. J Physiol 191: 225, 1967.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • R. S. Cole
    • 1
  • C. H. Fry
    • 2
  1. 1.Lithotripter CentreSt. Thomas’ HospitalLondonEngland
  2. 2.Department of Applied PhysiologySt. Thomas’ HospitalLondonEngland

Personalised recommendations