Does Hued Lubricant Jelly Prevent Stone Migration/Retropulsion During Semi-rigid Ureterorenoscopy and Pneumatic Lithotripsy?
Journal Title: JOURNAL OF UROLOGICAL SURGERY - Year 2019, Vol 6, Issue 1
Abstract
Objective: The aim of this study is to study the efficacy of hued lubricating jelly instillation proximal to the upper ureteral stone during intracorporial pneumatic lithotripsy using semi-rigid ureteroscope for the prevention of migration of the stone. Materials and Methods: We enrolled 60 subjects with ureteral stone in this prospective, controlled clinical trial. Alternate patients were assigned to the hued lubricating jelly instillation group A (n=30) and control group B (n=30). Ureteroscopy was performed according the standard protocol, using 7.5 F semi-rigid ureteroscope and stone fragmentation by pneumatic lithotripter. In the group A patients, a 5 Fr catheter was inserted into the ureter under fluoroscopy and 3-5 mL of hued lubricant jelly was dispensed above the stone. Retropulsion and the presence of residual fragments were evaluated with computed tomography of kidneys, ureters and bladder, X-ray and ultrasonography at 24 hours and at two weeks. The migrated stones were treated with shock wave lithotripsy. Any adverse event was reported and graded as per the modified Clavien classification system. Results: The two groups had comparable demographic and stone characteristics. There was a statistically significant difference in retropulsion rate between the lubricating jelly instillation group and control group (6.67% vs 26.67%, p=0.04). No statistically significant complications were noted amongst the two groups. All patients were stone-free at 2-week follow-up. Conclusion: Instillation of hued lubricating jelly proximal to ureteral calculi during pneumatic lithotripsy is an effective method of preventing retrograde stone migration.
Authors and Affiliations
Siddalingeshwar Neeli, Amey Patil, Srikanth Pentyala
Keywords
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