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A Randomized Clinical Trial of Lidocaine Jelly for Prevention of Inadvertent Retrograde Stone Migration During Pneumatic Lithotripsy of Ureteral Stone

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2008.05.008

1527-3792

Ali Akbar Zehri, M Hammad Ather, Khurram Siddiqui, M. Nasir Sulaiman,

Dental Anxiety and Anesthesia Techniques

No AccessJournal of UrologyAdult Urology1 Sep 2008A Randomized Clinical Trial of Lidocaine Jelly for Prevention of Inadvertent Retrograde Stone Migration During Pneumatic Lithotripsy of Ureteral Stone Ali A. Zehri, M. Hammad Ather, Khurram M. Siddiqui, and M. Nasir Sulaiman Ali A. ZehriAli A. Zehri , M. Hammad AtherM. Hammad Ather , Khurram M. SiddiquiKhurram M. Siddiqui , and M. Nasir SulaimanM. Nasir Sulaiman View All Author Informationhttps://doi.org/10.1016/j.juro.2008.05.008AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied the efficacy of lidocaine jelly instillation proximal to the ureteral stone during intracorporeal lithotripsy using a semirigid ureteroscope for the prevention of retrograde migration and improvement in stone-free rate. Materials and Methods: From November 2006 to September 2007, 50 patients with 5 to 18 mm ureteral stones undergoing ureteroscopic removal using pneumatic lithotripsy were randomized into 2 groups. Group 1 (25 patients) had lidocaine jelly instilled proximal to the stone before and after fragmentation, and group 2 was the control group (25 patients). Ureteroscopy was performed using an 8 or 6.4Fr semirigid ureteroscope. A 5Fr ureteral stent was advanced beyond the stone. Lidocaine jelly (2 ml) was instilled and lithotripsy was performed with a Swiss LithoClast™. A 5Fr ureteral catheter was left in place for 24 hours. Patients were followed at 24 hours with plain x-ray of the kidneys, ureters and bladder, and at 2 weeks with noncontrast enhanced computerized tomography of the kidneys, ureters and bladder. Results: The 2 groups were comparable with regard to age and stone size. Stone or stone fragment migration occurred in 4% and 28% of patients in groups 1 and 2, respectively, and this difference was statistically significant (p = 0.002). At 2 weeks followup with imaging the stone-free rate was 96% and 72% in groups 1 and 2, respectively, and this difference was also statistically significant (p = 0.045). Although the mean operative time was slightly longer in the treatment group (33.56 ± 13 vs 35.84 ± 12.5 minutes) the difference was not significant (p = 0.450). Conclusions: Lidocaine jelly instillation proximal to ureteral calculi during lithotripsy is an effective method of preventing retrograde stone displacement as well as significantly improving the stone-free rate. References 1 : A 10-year experience of managing ureteric calculi: changing trends towards endourological intervention–is there a role for open surgery?. BJU Int2001; 88: 173. Google Scholar 2 : Emergency ureteroscopic management of ureteral stones: why not?. Urology2007; 69: 27. 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Google Scholar Department of Surgery, The Aga Khan University, Karachi, Sind, Pakistan© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byUrsiny M and Eisner B (2012) Cost-Effectiveness of Anti-Retropulsion Devices for Ureteroscopic LithotripsyJournal of Urology, VOL. 189, NO. 5, (1762-1766), Online publication date: 1-May-2013.Rane A, Bradoo A, Rao P, Shivde S, Elhilali M, Anidjar M, Pace K and D'A Honey J (2010) The Use of a Novel Reverse Thermosensitive Polymer to Prevent Ureteral Stone Retropulsion During Intracorporeal Lithotripsy: A Randomized, Controlled TrialJournal of Urology, VOL. 183, NO. 4, (1417-1423), Online publication date: 1-Apr-2010. Volume 180Issue 3September 2008Page: 966-968 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordslidocainecalculiureteroscopyMetricsAuthor Information Ali A. Zehri More articles by this author M. Hammad Ather More articles by this author Khurram M. 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