Ureteric Stone
Conditions
Keywords
Laser, URS, DJ Stent, Lithotripsy, ESWL, URSL
Brief summary
Ureteroscopic laser lithotripsy is becoming the most commonly utilized treatment for patients with ureteral stone. The Holmium: YAG laser is integral to the operation and is the preferred flexible intracorporeal lithotripsy. It is considered cost-effective and efficient choice in ureteroscopic lithotripsy on all types of stones. As in recent years, there has been increasing interest in examining the effect of varying the laser settings on the effectiveness of stone treatment. The objective of the study is to compare the fragmentation and dusting modalities utilizing Holmium YAG laser in ureteroscopy for ureteral stone treatment. It will be a randomized control trial (RCT) in which 160 patients visiting Sahiwal Teaching Hospital, Sahiwal will be included. The patients will be divided into two groups. Group-A patients will be treated with fragmentation modality utilizing Holmium YAG laser while Group-B patients will be treated with dusting modality utilizing Holmium YAG laser. Simple random sampling technique will be carried out. The patients' age, gender, stone number, stone laterality, stone location, ureteral condition, reteropulsion, stricture formation, stone clearance, operative time, hospital stay, presence of retropulsion and complications will be recorded. Data will be collected through proforma, which will be entered and analyzed using SPSS version 26.0. For quantitative variables such as: age, operation time, hospital stay, stone number ,mean and standard deviation will be calculated and for qualitative variables such as: gender, and laterality, stone location, ureter condition, prevalence of pyuria, stone clearance, presence of retropulsion, ureter injury, frequency and percentages will be calculated. Data will be presented in tables and graphs for both quantitative and qualitative variables. Chi-square test will be used to estimate the association between study variables. P-value \<0.05 will be considered significant. It is anticipated that the results of this study will be helpful for health care planners and surgeons to provide better treatment option to the patients with ureteral stone.
Interventions
PROCEDURELASER Lithotripsy ( Fragmentation modality)
Group-A patients will be treated with fragmentation modality utilizing Holmium YAG laser.
PROCEDURELASER lithotripsy (Dusting Modality)
Group-B patients will be treated with dusting modality utilizing Holmium YAG laser.
Sponsors
District Headquarters Teaching Hospital Sahiwal
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
15 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Stone size 1cm to 1.5cm at proximal Ureter. 2. Patients aged between 15 to 70 years. 3. Both genders.
Exclusion criteria
1. Patients with active urinary tract infection 2. Pregnancy 3. Immunocompromised patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stone Free Rate | There would be 4 follow up visits. First visit will be after 1 week of URSL and X Ray KUB will be done. Second visit will be after 2 weeks of URSL and we will plan the removal of DJ stent. Those cases in which ureteral inury is suspected or stone burden | Stone-free will be defined as no residual stones \> 3 mm in the ureter of the affected side at one month postoperatively on computerized tomography (CT KUB Plain). |
| Reteropulstion | During procedure. | Retropulsion, defined as unintended migration of stone into the kidney, leads to failure and results in a lower SFR. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Uretral Stricture Formation | Post-URS ureteral stricture is defined as complete or partial ureteral obstruction as shown by the excretory phase of CTU, which was confirmed with delayed or absent radioactive tracer washout at 8 weeks after stent removal. | Post-URS ureteral stricture is defined as complete or partial ureteral obstruction as shown by the excretory phase of CTU, which was confirmed with delayed or absent radioactive tracer washout at 8 weeks after stent removal. |
Countries
Pakistan
Outcome results
None listed