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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03526458
Other study ID # 2017-0252
Secondary ID A539800SMPH/UROL
Status Completed
Phase N/A
First received
Last updated
Start date July 30, 2019
Est. completion date March 24, 2021

Study information

Verified date August 2020
Source University of Wisconsin, Madison
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The primary objective of this study is to compare the time to acceptable stone fragmentation during clinical use of the holmium laser when using energy settings 0.2J vs 0.8J. The hypothesis is that holmium laser energy settings 0.8J will require less time than lower energy settings 0.2J for fragmenting urinary stones. The clinical practice is to treat urinary stones until the stone is reduced to fragments ≤ 2 mm in size. This is determined by using the laser fiber which is 273 microns to visually estimate the size of the resultant fragments as described by Patel et al, J Endo 2014. Investigators will standardize the effect of stone size by creating a ratio of stone size to treatment time. In this study, the frequency is set at 15Hz. Thus, the study contains two arms: 0.2J&15Hz, and 0.8J&15Hz. Patients will be randomized into the two groups by the ratio of 1:1.


Description:

The only interventions imposed on subjects as a result of this study are (1) pre-procedural randomization to laser lithotripsy with either 0.2J or 0.8J energy setting, and (2) the use of patient information in describing results. All the other activities are part of the routine clinical practice in the department. Participation in the study will not alter the patients' preoperative, or postoperative care. During surgery, patients' stones will be treated in accordance with the routine clinical practice of fragmenting stones into small pieces (<2 mm). All patients enrolled will undergo routine post-operative follow up including clinic appointments and imaging evaluation. Any complications will be recorded, reported, and treated appropriately. A fixed frequency will be used (15Hz). Thus, the study contains two arms: 0.2J&15Hz, and 0.8J&15Hz. Patients will be randomized into the two groups by the ratio of 1:1. A total of 1 clinic visit (i.e., the stone surgery, approximately 5-6 hours, depending on the duration of the surgery) is needed for this study. The study procedures are: 1. A study team member who is affiliated with the patient's clinical care (e.g., the surgeon) will initially approach the patients who are scheduled laser lithotripsy treatment of urinary stones. (i.e. informed that there's a research study they may be eligible for, and asked if they want to learn more about it). 2. If the patient is interested in the study, a member of the research team will approach him/her for enrollment. 3. Once the consent form is obtained, patients' medical background will be reviewed for inclusion/exclusion criteria. Patients who meet the inclusion criteria will be included in the study; patients who do not meet the inclusion criteria will be excluded. 4. Patients will be randomized to either 0.2J&15Hz or 0.8J&15Hz (randomization ratio 1:1) group. 5. Patients will undergo stone surgeries with the laser setting that they are randomized to. The patient's stone(s) will be treated in accordance with the routine clinical practice of fragmenting stone into small pieces (≤ 2mm). The faculty surgeon (i.e., Dr. Nakada) will perform all surgeries. 6. Fragmentation time as well as other information (total surgery time, complications, stone information, and number of stones treated) is collected. 7. After surgery, the patients will then continue on normal postoperative pathway. Postoperative complications will be collected.


Recruitment information / eligibility

Status Completed
Enrollment 40
Est. completion date March 24, 2021
Est. primary completion date March 24, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Patients at least 18 years of age - Patients with urinary stones who require endoscopic treatment Exclusion Criteria: - Patients < 18 years of age - Pregnant patients - Pre-menopausal females who have not been on approved birth control for at least 1 month pre-operatively - Patients with stones known to be refractory to treatment with the holmium laser

Study Design


Intervention

Device:
Holmium:YAG laser
Treatment of urolithiasis is commonly done using the holmium:YAG laser as this has been shown to be a safe and effective method of treating a wide variety of stones and is currently considered the standard of care (AUA Guideline Panel on the Surgical Management of Stones)

Locations

Country Name City State
United States University of Wisconsin Madison Wisconsin

Sponsors (1)

Lead Sponsor Collaborator
University of Wisconsin, Madison

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Fragmentation Time The time to fragment a stone into small pieces (=2 mm, which is our current institutional practice) up to 6 hours
Secondary Total Operative Time up to 6 hours
Secondary Pre-Operative Stone Size Pre-operative stone size (on pre-operative CT) will be reported in millimeters. Retrospective review of health chart at Baseline
Secondary Number of Participants With Either Ureteral or Renal Location of Urinary Stone Urinary stone location will be classified as renal or ureter. up to 6 hours
Secondary Number of Participants Treated for Either Single or Multiple Urinary Stones up to 6 hours
Secondary Density of Urinary Stones up to 6 hours
Secondary Number of Participants With Urinary Stone Fragment Size of 1, 2 or 3 mm Size of fragments created will be assessed using the laser fiber size as a comparison. up to 6 hours
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