EFFICACY OF LIDOCAINE JELLY IN PREVENTION OF PROXIMAL MIGRATION OF URETERIC CALCULI DURING INTRACORPOREAL LITHOTRIPSY
General Surgery (East Africa)
introduction & Objectives:
To asses the efficaes of lidocaine jelly instillation proximal to the ureteral stone during intra corporeal lithotripsy using semi rigid ureteroscope in the prevention of retrograde migration and stone free rate.
Material & Methods:
From November 2006 to July 2007, 50 patients with 5-20 mm. Ureteral stones undergoing ureteroscopic removal using had Lidocaine jelly had Lidocaine jelly instilled proximal to stone before start of fragmentation and control group 2 (n=25). Ureteroscopy was performed using a 9.8 or 6.4 Fr semi rigid ureteroscope. A 5F ureteral stent was advanced beyond the stone. Lidocaine jelly (2 mL) was instilled, and lithotripsy was done with a Swiss Lithoclast™. A 5F ureteral catheter was left in place for 24 hours, and patients were followed up at 24 hours with imaging at 2 weeks with intravenous urography or non-contrast-enhanced CT. Results: The two groups were comparable with regard to age and stone size. Stone or stone fragment migration occurred in 4% of group 1 and 28% of the controls (group2), the difference was statistically significant (p _0.002). At 2 weeks followed up with IVU the stone-free rate was 966.0% and 72.0% in the treatment and control groups, respectively, and the difference between the two groups was statistically significant (p 0.045). Although the mean operative time was slightly longer in the treatment group (33.56 versus 35.84 minutes), the difference was not significant (p_ 0.450).
Lidocaine jelly installation proximal to the ureteral calculi during lithotripsy is an effective method to prevent retrograde stone displacement, with significant improvement in stone-free rate as well.
European Urology Supplements
Ather, H., Zehri, A., Siddiqui, K., & Sulaiman, N. (2008). Efficacy of lidocaine jelly in prevention of proximal migration of ureteric calculi during intracorporeal lithotripsy. European Urology Supplements, 3(7), 106.