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 compare the effectiveness of the Dormia™ stone basket and lidocaine jelly installation proximal to the ureteral stone for prevention of retrograde migration and improvement of stone-free rate.

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: Compared to lidocaine jelly, Dormia basket increased the rate of stone migration, although the difference was not statistically significant. Both approaches considerably increased stone movement and stone-free state as compared to no intervention, with a higher correlation 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