Stones, Kidney
Conditions
Keywords
Kidney stones, Flexible ureteroscopy, Quality of life, drainage
Brief summary
Flexible ureterorenoscopy (FURS) is now recommended for the treatment of kidney stones smaller than 20 mm, as an alternative to extracorporeal shock wave lithotripsy (ESWL) and in combination with percutanous nephrolithotomy (PCNL) for stones larger than 20 mm. At the end of the operation, a ureteral drainage is put in place for the treatment of residual fragments and the inflammation following the ureteroscopy. It helps prevent obstructive symptoms and the development of strictures. Drainage is done either by a ureteral catheter or by a double J stent. In the literature, while drainage after ureteroscopy is recommended, the criteria for choosing between these two options are not clearly defined. The objective of this study will be to assess whether the type of postoperative drainage after URS for kidney stones can influence the perioperative outcomes and health-related quality of life.
Detailed description
Flexible ureterorenoscopy (FURS) is now recommended for the treatment of kidney stones smaller than 20 mm, as an alternative to extracorporeal shock wave lithotripsy (ESWL) and in combination with percutanous nephrolithotomy (PCNL) for stones larger than 20 mm. At the end of the operation, a ureteral drainage is put in place for the treatment of residual fragments and the inflammation following the ureteroscopy. It helps prevent obstructive symptoms and the development of strictures. Drainage is done either by a ureteral catheter or by a double J stent. In the literature, while drainage after ureteroscopy is recommended, the criteria for choosing between these two options are not clearly defined. The objective of this study will be to assess whether the type of postoperative drainage after URS for kidney stones can influence the perioperative outcomes and health-related quality of life.
Interventions
PROCEDUREFlexible ureteroscopy for renal calculi less than 20 mm
Patients with renal calculi less than 20 mm will be managed by flexible ureteroscopy. at the end of the procedure, they will be randomized to receive either temporary ureteral catheter for 2 days or indweeling double J stent for 2-4 weeks
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 1- Adult patients (aged \>18 years) 2- Undergo unilateral uncomplicated retrograde intrarenal surgery (RIRS) using flexible ureterorenoscopy.
Exclusion criteria
1. Residual ureteral or renal stones after the procedure as documented by the surgeon 2. Patients who will need auxiliary procedures (ESWL , re-FURS or PCNL) 3. Preoperative febrile UTI 4. pregnancy or breastfeeding 5. Bilateral ureteroscopic surgery 6. Single kidney 7. Chronic kidney disease 8. Cardiovascular or cerebrovascular disease 9. Hepatic dysfunction 10. Other acute medical conditions as acute gastroenteritis, osetoarthritis that might influence the patient QoL
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stone free rate | 12 weeks after the procedure | presence of residual fragments on non contrast computed tomography |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| perioperative complications | First 3 days postoperative | perioperative complications after the procedure |
| Postoperative pain by visual analogue scale | first 24 hours postoperatively | Visual analogue scale will be assessed postoperative |
Countries
Egypt
Outcome results
None listed