The Efficacy of Using Lidocaine Jelly 2% for Prevention of Inadvertent Retrograde Stone Displacement during Pneumatic Lithotripsy of Upper Ureteral Stone

Aimto assess the efficacy of lidocaine jelly instillation proximal to the upper ureteral stone during intracorporial pneumatic lithotripsy using semirigiduretroscope for the prevention of retrograde migration and improvement in stone free rate. Forty patients with upper ureteric stone were studied in Al-Yarmouk Teaching Hospital /Baghdad/ Iraq during the period from February 2015 to December 2015. Patients were randomly divided into two equal groups, group (A) patients were undergone pneumatic lithotripsy using lidocaine jelly 2 % proximal to the ureteric stone. Group (B) patients underwent the pneumatic lithotripsy without using lidocaine jelly. A 5Fr double J was left in place for 4 weeks & patients were followed up with ultrasound & CT for abdomen & pelvis. It was found that the 2 groups were comparable with regard to age & stone size. Stone or its fragment migration occurred in 5 % & 30 % of patients in group A & B respectively, a significant difference P=0.0382. At 4 weeks follow up with imaging, the stone free rate was 95 % & 65 % in group A & B respectively. This difference was also statistically significant (p=0.01711). Although the mean operative time was slightly longer in the group A (42 10 minutes) than in group B (40 10 minutes), the difference was not significant (p=0.361). We concluded that lidocaine jelly instillation proximal to ueretral calculi during pneumatic lithotripsy is an effective method of preventing retrograde stone displacement as well as significantly improving the stone free rate.