Early experience of intra-ureteric capsaicin infusion in loin pain haematuria syndrome

Objectives To evaluate early results of the intra-ureteric instillation of capsaicin for the treatment of loin pain haematuria syndrome (LPHS). Patients and methods Ten patients with LPHS were treated using intra-ureter ic capsaicin instillation, A solution of capsaicin was infused into the aff ected ureter through an embolectomy catheter, under anaesthesia, The succes s of the treatment was assessed using patient questionnaires and the quanti tative reduction in the patients' analgesic requirements measured. Results During a mean follow-up of 6 months, six of the 10 patients had sho rt- to medium-term symptomatic relief after one or more treatments; four ha d no relief from their symptoms, One patient had a mucosal ulceration in th e bladder after extravasation of the capsaicin solution. Two patients subse quently underwent simple nephrectomy for symptomatic nonfunctioning kidneys . Conclusion These results are consistent with other preliminary reports of t he efficacy of capsaicin treatment in LPHS and such treatment therefore has a definite therapeutic role in this difficult condition. We are uncertain if the treatment contributed to the deterioration of the excised kidneys. T his early experience suggests a need for careful consideration when contemp lating this treatment, with attention directed to both the initial diagnosi s and possibly the technique of capsaicin/instillation. We include a protoc ol to follow when preparing patients for capsaicin treatment.