A Multicenter Prospective Research on the Treatment of Low Pole Renal Calculus by Flexible Ureteroscope
Study Details
Study Description
Brief Summary
This study centers on the treatment of low pole renal stones by flexible ureteroscope and intends to find the key anatomical parameters using a prospective, randomized multi-center trial design and to make a more appropriate standard for flexible ureteroscopy of low pole renal stones.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
With the development of manufacturing technique, new generation of flexible ureteroscopes have great initiative and passive bending capacity and have greatly expanded its application. In our clinical practice, we have found that IPA (Infundibulopelvic angle) is no longer a decisive factor for the success of f-URS（flexible ureteroscope） surgeries. Thus, we think it is necessary to have further study on the effect of anatomy of renal collecting system for f-URS surgeries.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Low Pole Renal Calculus patients with low pole renal calculus who are suitable to treat by flexible ureteroscopy |
Procedure: Flexible Ureteroscopy
the Treatment of Low Pole Renal Calculus by Flexible Ureteroscope
|
Outcome Measures
Primary Outcome Measures
- whether the f-URS could enter the low kidney calyx or not [during the operation]
Following conditions are regarded as failures: 1. the f-URS couldn't enter the low kidney calyx 2. Though the f-URS has entered the low kidney calyx, it cannot crush the stone.
Secondary Outcome Measures
- stone clearance [4 weeks post-operatively]
Check NECT（nonenhanced CT）, no residual or residual stones are smaller than 2mm in total refers to clear success.Number of participants undergo f-URS surgeries without residual calculus/Total number of participants in each group *100%=stone clearance
Eligibility Criteria
Criteria
Inclusion Criteria:
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• Subject has provided informed consent and indicated a willingness to comply with study treatments
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Subject is 18-70 yrs of age
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Subject can be either male or female
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Subject has a diagnosis of low pole renal stones according to CT urography(CTU) or intravenous pyelogram (IVP) results
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Subject has a single stone 12cm in size (KUB), or multiple stones 12cm in cumulative size (KUB), and is a surgical candidate for the ureteroscopic approach
Exclusion Criteria:
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• Subject has an active urinary tract infection (e.g., cystitis, prostatitis, urethritis, etc.)
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Subject has been diagnosed with a urethral stricture or bladder neck contracture
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Subject has been diagnosed with a urinary tract infection related to stone obstruction within two weeks
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Subject has severe hematuria that might blur the vision of the endoscopy
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Subject is pregnant or in monthly period
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Subject has coexistent disease like systemic disease, heart disease, lung disfunction or other diseases that could not tolerate the endoscopic surgery or anesthesia.
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Subject has unadjusted diabetes or high blood pressure
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Subject has a disorder of the coagulation cascade system that would put the subject at risk for intraoperative or postoperative bleeding
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Subject is unable to discontinue anticoagulant and antiplatelet therapy preoperatively (2 weeks)
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Subject has been diagnosed with hydronephrosis larger than 3cm according to the B-scan ultrasonography examination
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Subject has any kind of anatomic abnormality of the urinary system that might have an influence on the surgery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Changhai Hospital | Shanghai | Shanghai | China | 200433 |
Sponsors and Collaborators
- Changhai Hospital
- Shanghai Changzheng Hospital
- The First Affiliated Hospital of Anhui Medical University
- Tongji Hospital
- Renmin Hospital of Wuhan University
- The Second People's Hospital of GuangDong Province
- Jiangsu Provincial People's Hospital
- The First Affiliated Hospital of Nanchang University
- West China Hospital
- The First Affiliated Hospital of Xiamen University
- Zhejiang Provincial People's Hospital
Investigators
- Principal Investigator: Gao Xiaofeng, MD, Changhai Hospital
Study Documents (Full-Text)
None provided.More Information
Additional Information:
- Flexible ureterorenoscopy for lower pole stones: influence of the collecting system's anatomy
- The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones
- Ureteroscopy--an essential modern approach in upper urinary tract diagnosis and treatment
- Impact of lower pole renal anatomy on stone clearance after shock wave lithotripsy: fact or fiction
- Predictive factors of lower calyceal stone clearance after extracorporeal shockwave lithotripsy (ESWL): the impact of radiological anatomy
- Measurement of renal anatomy for prediction of lower-pole caliceal stone clearance: reproducibility of different parameters
- Do new generation flexible ureterorenoscopes offer a higher treatment success than their predecessors?
- Pushing the boundaries of ureteroscopy: current status and future perspectives
Publications
None provided.- SHOT-20161208