Urolithiasis management in emergency settings often necessitates invasive procedures, contributing to high healthcare costs, hospital admissions, and patient discomfort. Current standard treatments for small urethral and bladder stones typically involve endoscopic interventions under anesthesia. This study aims to evaluate a novel, minimally invasive, office-based method for treating urethral and bladder stones up to 7 mm in size using a local anesthetic gel, focusing on patient comfort, cost reduction, and avoidance of surgical intervention.

This retrospective study analyzed data from 40 patients presenting with urethral or bladder stones measuring ≤7 mm. The initial step involved displacing any urethral stone into the bladder. Patients were subsequently discharged with a Foley catheter placement and prescribed tamsulosin to promote urethral relaxation. After seven days, Instillagel (local anesthetic and lubricant) was instilled into the urethra to facilitate the natural expulsion of the stone during voiding. Treatment success rates, complications, and healthcare cost savings were recorded and statistically analyzed.

Successful stone passage was achieved in 34 out of 40 patients (85%). The average stone size among the cohort was 6 mm. No major complications were reported, and minor discomfort resolved spontaneously. The office-based method demonstrated a 70% cost reduction when compared to traditional surgical intervention for similar stone sizes.

This novel minimally invasive technique using local anesthetic gel effectively facilitated the passage of small stones without the need for surgical intervention. The strategy not only demonstrated a high success rate but also provided significant economic benefits and improved patient comfort, suggesting its potential as a standard approach for selected cases.

An office-based technique utilizing local anesthetic gel represents a safe, effective, and cost-efficient method for managing small urethral and bladder stones. This approach offers a practical outpatient solution and may help decongest surgical services. Further prospective studies with larger sample sizes are warranted to confirm its broader applicability and potential to treat larger stones.