Ureter Obstruction
Conditions
Brief summary
To evaluate the role of both primary and deferred URS in the management of calculus anuria concerning the feasibility, clinical outcome, and cost-effectiveness in children in a comparative study
Detailed description
Thirty group B (30) patients will be admitted to do urinary drainage through the insertion of a JJ stent or percutaneous nephrostomy (PCN) at first , then a deferred URS will be done children will undergo primary URS( group A ) and in. Ureteral dilatation will be done when the stone size exceeds 10 mm to facilitate the extraction of the fragments. Ureteroscopic lithotripsy will be done using a 6.5:7.5 Fr semi-rigid ureteroscope and holmium laser. The ureteric stent will last for one week after lithotripsy. Postoperatively, the patients in both groups will monitored for post obstructive diuresis, fever, hematuria, and extent of renal function improvement.
Interventions
PROCEDUREPrimary ureterscopy URS
Ureteral dilatation will be done when the stone size exceeds 10 mm to facilitate the extraction of the fragments. Ureteroscopic lithotripsy will be done using a 6.5:7.5 Fr semi-rigid ureteroscope and holmium laser. The ureteric stent will last for one week after lithotripsy
PROCEDUREdeferred ureteroscopy URS
insertion of a double -J stent or percutaneous nephrostomy (PCN) at first , then a deferred ureteroscopy URS will be done .
Sponsors
South Valley University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Children ˂12 years with calculus anuria. * Clinically stable (serum creatinine \< 3.5 mg/dl, blood urea \< 100 mg/dl,serum potassium level \< 7 milliequivalent /L and /or ph of blood \> 7.1) * All the patients free of sepsis.
Exclusion criteria
* Unstable children (serum creatinine ≥ 3.5 mg/dl, blood urea ≥ 100 mg/dl, serum potassium ≥ 7 milliequivalent/l, and/or blood pH ≤ 7.1, signs of acidosis, sepsis, or fluid retention). * Children with underlying urological structural abnormalities
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| renal function | one month . | improvement in creatinine level mg/dl urea level mg/dl |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| the stone-free rates | one month | The clinical outcomes of the procedures including the perioperative complications : * of perforation * of infection * of residual stones * of the stone-free rates |
Countries
Egypt
Contacts
Primary Contactmostafa mostafa, B.sc
Outcome results
None listed