Lidocaine jelly with the Dormia Stone Basket: Preventing Retrograde Ureteric Stone Migration During Pneumatic Lithotripsy

Original Article

Abstract

Background: Ureteroscopy for kidney stones has undergone a great deal of improvement over time, but stone migration is still an issue. Dormia TM stone baskets and lidocaine jelly installations are a few of the methods for prevention.

Objectives: To evaluate the impact of installing lidocaine jelly close to the ureteral stone and the DormiaTM stone basket in terms of preventing retrograde migration and increasing the rate of stone-free passage.

Study Design: A Retrospective Study.

Place and duration of study. Department Of Urology Aga Khan Hospital Karachi From Jan 2021 To Dec 2021

Methods: 185 patients were divided into three groups based on retrospective analysis of data from Aga Khan Hospital in Dar es Salaam: Group 1 (Dormia basket), Group 2 (Lidocaine jelly), and Group 3 (no intervention). Two weeks and 24 hours later, follow-up radiological imaging was performed. Our finding: The three groups' sizes of stones and demographics were similar. In Groups 1, 2, and 3, stone-free rates were 98.4%, 92.5%, and 80.4%, respectively, whereas stone fragment migration occurred in 1.6%, 6.5%, and 19.6% of cases. In comparison to the no-intervention group, stone fragment migration was significantly different in the intervention group (p = 0.002 for Group 1 and p = 0.050 for Group 2). Group 1 versus Group 3 (p = 0.001) and Group 2 vs Group 3 (p = 0.030) showed statistically significant differences between the groups. However, there was no significant difference between Group 1 and Group 2 (p = 0.365).

Conclusions: The frequency of stone migration was higher with the Dormia basket than with lidocaine jelly, although the difference was not statistically significant. When compared to no intervention, both strategies significantly boosted stone mobility and the state of being stone-free, with a stronger correlation being shown with the Dormia basket. Our study showed a significant reduction in stone migration and an improved stone-free rate with the use of a Dormia basket or lidocaine jelly during ureteroscopy as compared to the no-intervention group. Dormia could be adapted as a cost-effective technique in resource-limited settings such as ours.

Keywords: Retrograde stone migration, Dormia basket, and lidocaine jelly, Ureteroscopy