EFFICACY AND SAFETY OF LUBRICATING JELLY INSTILLATION TO PREVENT RETROPULSION DURING URETEROLITHOTRIPSY FOR URETERAL STONES
Abstract: We studied the
efficacy and safety of lubricating jelly instillation before ureterolithotripsy
for prevention of retropulsion and improvement in stone-free rate. Material
& methods: We enrolled 22 subjects with ureteral stone in this prospective,
randomized, single-blind and controlled clinical trial. Each subject was
randomly assigned to the lubricating jelly instillation group (n=11) and
control group (n=11). Ureteroscopy and lithotripsy was performed according the
standard protocol, using 9.8 F semirigid ureteroscope and pneumatic
lithotripter. A 6 F ureteral catheter was advanced beyond the stone, and
lubricating jelly was instilled through the catheter lumen. Retropulsion and
the presence of residual fragments were evaluated with plain kidneys, ureters
and bladder x-ray and ultrasonography, or Non Contrast-enhanced Computed
Tomography. Any complication was reported and graded using the Modified Clavien
Classification System.
Results: The 2 groups had comparable preoperative characteristics. There
were no statistically significant difference between the lubricating jelly
instillation group and control group regarding the retropulsion rate (54.5% vs
72.7%, ρ=0.375), the stone-free rate (54.5% vs 36.4%, ρ=0.392), and the
complication rate (45.5% vs 54.5%, ρ=0.670). Conclusion: Lubricating jelly
instillation during ureterolithotripsy has limited value for prevention of
retropulsion and improvement in stone-free rate.
Keywords: Ureterolithotripsy;
retropulsion; lubricating jelly instillation
Author: Rameshdo Yuanda, Doddy
M Soebadi, Soetojo, Sunaryo Hardjowijoto
Journal Code: jpkedokterangg170033
