Office bladder distention with Electromotive Drug Administration (EMDA) is equivalent to distention under General Anesthesia (GA)

BACKGROUND: Bladder distention is commonly used in diagnosis and treatment of interstitial cystitis (IC). Traditionally performed in the operating room under general or spinal anesthesia (GA), it is expensive and associated with short term morbidity. Office bladder distention using electromotive drug administration (EMDA) has been suggested as an alternative that is well tolerated by patients. We report the first comparative findings of patients undergoing both office distention with EMDA and distention in the operating room (OR) with GA. METHODS: This retrospective chart review identified 11 patients participating in two protocols of EMDA bladder distention who also underwent bladder distention under GA either prior to or after the EMDA procedure. RESULTS: The median absolute difference in bladder capacity between GA and EMDA was only 25 cc; the median percent difference was 5%. Cystoscopic findings, while not prospectively compiled, appear to have been similar. CONCLUSION: This study represents the first comparison between distention with EMDA versus GA and confirms the technical feasibility of performing bladder distention in an office setting. The distention capacity achieved in the office was nearly identical to that in the OR and the cystoscopic findings very similar. Further investigation into the comparative morbidity, cost, and other outcome measures is warranted to define the ultimate role of EMDA bladder distention in the clinical evaluation and care of patients with IC

Linear and cyclic carbamates via dialkyl carbonate chemistry

Dialkyl carbonates (DACs) as reagents have found recent application in phosgene-free synthesis of both linear and cyclic carbamates. Different type of catalysts have been investigated for the carbamoylation of aniline via dimethyl carbonate (DMC) in batch. The possibility of conducting this reaction in a fixed bed continuously fed reactor has been investigated. DACs have also been employed in a novel green approach to six-membered cyclic carbamates (1,3-oxazolidin-2-ones). Reaction of primary amines or hydrazines with bis(methyl carbonate) derivatives of 1,3-propandiols in the presence of potassium tert-butoxide resulted in the synthesis of several 1,3-oxazolidin-2-ones in good yield. These compounds can also be prepared by a one-step intermolecular cyclization where the 1,3-bis(methyl carbonate) intermediate is formed in situ.Dialkyl carbonates (DACs) as reagents have found recent application in phosgene-free synthesis of both linear and cyclic carbamates. Different types of catalysts have been investigated for the carbamoylation of aniline via dimethyl carbonate (DMC) in batch. The possibility of conducting this reaction in a fixed-bed continuously fed reactor has been investigated. DACs have also been employed in a novel green approach to six-membered cyclic carbonates (1,3-oxazolidin-2-ones). Reaction of primary amines or hydrazines with bis(methyl carbonate) derivatives of 1,3-propanediols in the presence of potassium tert-butoxide resulted in the synthesis of several 1,3-oxazolidin-2-ones in good yield. These compounds can also be prepared by a one-step intermolecular cyclization where the 1,3-bis(methyl carbonate) intermediate is formed in situ