�UroToday.com - Ureteroscopy is the most common interventional procedure in front symptomatic ureteral, not amenable to shock wave, lithotripsy. It has a identical high stone free rate. However, regress displacement of a calculus can occur during irrigation to keep patency and vision, or due to the lotion of kinetic energy used for stone fragmentation. The reported migration rate varies from 2% to 60%.
Various modifications of the existing technique have been described including the use of ureteral baskets, Lithocatch �, Lithovac�, Passport� Balloon and the Dretler stone cone (Boston Scientific, Natick, Massachusetts) etc. All of these add to the cost and complexness of he procedure. We have described a mere maneuver during ureterscopy to prevent inadvertent retrograde edward Durell Stone migration.
We tested instillation of xylocaine gel, proximal to stone, before lucy Stone fragmentation in a randomised clinical trial. Our results indicate in two like groups with regard to age and stone size, stone or stone shard migration occurred in 4% and 28% of patients in groups 1 (written report) and 2 (control), respectively, and this difference was statistically significant (p = 0.002).
At 2 weeks review with imagination, the stone-free rate was 96% and 72% in groups 1 and 2, respectively, and this difference was as well statistically substantial (p = 0.045). We over that Lidocaine jelly instilment, proximal to ureteral calculi during lithotripsy, is an effective method of preventing retrograde stone displacement as well as significantly up the stone-free rate.
One of the limitations of this technique is that if the working groove of the ureteroscope is used for this aim, it requires some force to bear on the gelatin through. Additionally, instillation of jelly has the voltage to spoil visibility during ureteroscopy. We did not collect data specifically addressing this way out, however none of the participating urologists experienced this problem in the current study.
Written by M. Hammad Ather, FCPS (Urol), as part of Beyond the Abstract on UroToday.com.
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