Renal Calculi
Conditions
Keywords
lithotomy position, lateral position, lower calyx, FURS, RIRS
Brief summary
Retrograde intrarenal surgery (RIRS) is an established minimally invasive treatment for renal stones, particularly for lower calyceal stones less than 2 cm, offering acceptable stone-free rates with low morbidity. However, stone clearance in the lower calyx remains technically challenging due to unfavorable anatomy, limited scope deflection, and gravity-dependent fragment retention. Patient positioning during RIRS has been suggested as a modifiable factor that may influence endoscopic access, stone relocation, and surgical ergonomics. The lithotomy position is conventionally used during RIRS, while the lateral position has been proposed to facilitate stone migration and improve lower calyceal access through gravitational assistance. Existing studies comparing patient positioning during RIRS are limited, with most evidence derived from retrospective analyses or non-randomized designs. Therefore, this randomized controlled trial aims to compare lithotomy versus lateral positioning during RIRS for lower calyceal stones less than 2 cm in terms of operative and clinical outcomes.
Interventions
PROCEDURELithotomy Position
Patients undergo RIRS in lithotomy position
PROCEDURELateral position
Patients undergo RIRS in lateral position
Sponsors
Menoufia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged ≥18 years. * Single or multiple lower calyceal renal stones with stone size \<2 cm confirmed by NCCT. * Negative urine culture. * Presented cases.
Exclusion criteria
* Multiple stones involving renal pelvis or other calyces. * Anatomical anomalies affecting ureteroscope access (horseshoe kidney, malrotation, ureteral strictures). * Pregnancy. * Prior ipsilateral renal surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stone Free Rate | 1 month | Stone-free rate (SFR), defined as no clinically significant residual stones on non-contrast 3-mm-cuts CT, measured as yes or no |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative time | The operative time | operative time is defined as time between starting the procedure and termination of it measured in minutes |
| Complications | 1 month | Intra and postoperative complications, defined as complications happens intraoperative and postoperatively, graded by modified clavien-dindo classification |
Countries
Egypt
Contacts
Primary ContactAmmar Alorabi
Outcome results
None listed