Urolithiasis Clinical Trial
Official title:
Dusting vs Basketing in RIRS: a Single-center Prospective Randomised Trial
The investigator aims to perform a prospective and randomized controlled trial comparing the safety and efficacy of active basket extraction of fragments and stone dusting during the RIRS.
RIRS has been widely adopted and used by urologists worldwide in the management of renal
stones due to less invasiveness and efficacy, especially in small to moderate-sized renal
stones. RIRS has several advantages over SWL for stones less than 2 cm diameter. Most
importantly, removing the stone in one session without the need for other treatment
modalities.
Furthermore, the application of RIRS has expanded to larger stones reaching up to 35 mm in
some cases,in spite of not being the first line therapy for the larger stones. RIRS has
advantages over the PCNL especially concerning complications. Namely lower or no bleeding
events and the less invasiveness of RIRS.
Options for the treatment of intrarenal stones include fragmenting the stone then extracting
large fragments using a basket or dusting the stone into very small fragments then leaving
the (dust) to pass spontaneously.
The idea of dusting in RIRS emerges as a counterpart of the originally taught fragmentation
and basketing of the stones. Aiming to reduce multiple entries and exits for the renal system
and ultimately not requiring UAS or baskets during the surgery. Thus theoretically decreasing
operative time and costs with the same SFRs, In addition to minimizing the risk of ureteral
injury .
So there is a debate amongst surgeons whether to laser the stone to dust or fragment and
retrieve intra-renal fragments. EAU guidelines on the surgical management of urolithiasis
stated that dusting strategies should be limited to the treatment of large renal stones.
Without clearly differentiating between dusting or fragmentation and basketing. Cho et al;
favored fragmentation technique especially for large renal stones because the dust in dusting
technique may affect visualization and obscure small stone fragments. But this was an opinion
and not built on a direct comparative study.
Until now, there is no consensus on how to achieve optimal stone clearance once the primary
stone is fragmented with lithotripsy. And to date, no prospective randomized study has
addressed the practice of active extraction vs. spontaneous passage
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Enrolling by invitation |
NCT04746378 -
PRedictive Accuracy of Initial Stone Burden Evaluation.
|
||
Recruiting |
NCT05100017 -
Methocarbamol vs Oxybutynin for Management of Pain and Discomfort S/P Ureteroscopy Procedure
|
N/A | |
Recruiting |
NCT04021381 -
Citrate Salts for Stone-free Result After Flexible Ureterorenoscopy for Inferior Calyx Calculi
|
Phase 3 | |
Completed |
NCT02266381 -
A Prospective Comparison of Fluoroscopic, Sonographic or Combined Approach for Renal Access in Percutaneous Nephrolithotomy
|
N/A | |
Terminated |
NCT01431378 -
Pilot Study of Model Based Iterative Reconstruction Using 64-Slice
|
N/A | |
Completed |
NCT01451931 -
Study of Tomography of Nephrolithiasis Evaluation
|
Phase 4 | |
Completed |
NCT01295879 -
Vitamin D Repletion in Stone Formers With Hypercalciuria
|
Phase 4 | |
Completed |
NCT02895711 -
Radiation Dose of Pediatric Patients During Ureteroscopy
|
||
Completed |
NCT05340075 -
Staged Bilateral Percutaneous Nephrolithotomy
|
||
Recruiting |
NCT03919227 -
Measurement of Resistance During UAS Insertion Procedure in RIRS
|
N/A | |
Recruiting |
NCT03717285 -
Under Direct Vision vs Under Non Direct Vision of Insertion of UAS in RIRS
|
N/A | |
Completed |
NCT05340088 -
Optimal Passive Dilation Time in Retrograde Intrarenal Surgery
|
||
Completed |
NCT05032287 -
Medical Expulsive Therapy Post-SWL For Renal Stones
|
N/A | |
Recruiting |
NCT05701098 -
SOUND Pivotal Trial - (Sonomotion stOne comminUtion resoNance ultrasounD)
|
N/A | |
Not yet recruiting |
NCT04080973 -
Metabolic Workup in Patients Suffering From Kidney Stone Disease and Osteopenia
|
N/A | |
Terminated |
NCT01736358 -
The Use of Intranasal Ketoralac for Pain Management (Sprix)
|
Phase 4 | |
Completed |
NCT01792765 -
Management of Ureteral Calculi Using Ultrasound Guidance: A Radiation Free Approach
|
N/A | |
Completed |
NCT06211842 -
Genetic Variations That Increase the Risk for Calcium Kidney Stones: a Family-based Study
|
||
Not yet recruiting |
NCT02214836 -
Ultrasound Imaging of Kidney Stones and Lithotripsy
|
N/A | |
Not yet recruiting |
NCT04606758 -
Fluoroscopic Guided vs US-guided Percutaneous Nephrolithotripsy for the Treatment of Stone Disease
|
N/A |