Stent Omission After Ureteroscopy and Lithotripsy in the Michigan Urological Surgery Improvement Collaborative

NCT ID: NCT05866081

Last Updated: 2025-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

792 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-01

Study Completion Date

2026-05-01

Brief Summary

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This is a multicenter prospective trial with randomized and observational cohorts assessing patient-reported outcomes and unplanned healthcare utilization following ureteroscopic treatment of renal and ureteral stones, with placement versus omission of a ureteral stent.

Eligible participants in the randomization trial will be randomized to ureteroscopy with stent placement or stent omission.

Eligible participants that consent to the observational only cohort will complete surveys and the treating physicians will decide the treatment options for the participants.

The study team hypothesizes that:

* Pain interference change from pre-surgery to Day 7-10 will differ between the two treatment arms. This hypothesis will be evaluated separately in the randomized and observational cohorts.
* Unplanned healthcare utilization in the treatment arms will have different unplanned healthcare utilization ranks leading to a win proportion significantly higher or lower than 0.5 in the stent omission arm compared to the stent placement arm. This hypothesis will be evaluated separately in the randomized and observational cohorts.

Detailed Description

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The coordinating center for this study is the Michigan Urological Surgery Improvement Collaborative (MUSIC), which is a physician-led Quality Improvement (QI) collaborative comprised of 44 urology practices and 260 urologists across the State of Michigan.

As sites are activated the registration will be updated.

Conditions

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Stone, Kidney Stone Ureter

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants that consent for the randomization cohort (264 anticipated) will be randomized using an online computer-based system to either stent omission or stent placement in a 1:1 ratio following secondary eligibility criteria. Blocked, stratified randomization based upon surgeon classified stone location (renal only versus ureteral with or without renal), with random block sizes will be used to ensure group balance.

Observational study participants (528 anticipated) will not be randomized.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers
Surgeons will remain blinded to this allocation until the surgeon has confirmed secondary eligibility.

Study Groups

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Randomized cohort- No stent placement

Participants that are eligible and consent for the randomization cohort of the trial will not have a stent placed.

If participants are found to be ineligible (see below) at the end of ureteroscopy the participants will not be randomized and taken off the study.

In randomization cohort, second stage eligibility criteria: ureteral perforation, unanticipated anatomic abnormality, greater than expected bleeding, ureteral dilation greater than 12 French, ureteral access sheath utilized, failed ureteroscopy, no or incomplete lithotripsy performed, unable to complete case due to medical or anesthetic event.

Group Type OTHER

No stent placement

Intervention Type OTHER

Participants not have a stent placed per randomization assigned if there are no complications (per protocol) during ureteroscopy that excludes the participant.

Surveys

Intervention Type OTHER

All participants in the trial cohort and observational arms will be asked to complete survey instruments (evaluating their pain, quality of life, and experiences following ureteroscopy, as well as surveys evaluating their opinions and preferences around ureteral stenting, etc.).

Participants will also have routine clinical data (preoperative, perioperative, and postoperative) to be collected and analyzed for research purposes.

Randomized cohort- Stent placement

Participants that are eligible and consent for the randomization cohort trial will have a stent placed.

If participants are found to be ineligible (see below) at the end of ureteroscopy the participants will not be randomized and taken off the study.

In randomization cohort, second stage eligibility criteria: ureteral perforation, unanticipated anatomic abnormality, greater than expected bleeding, ureteral dilation greater than 12 French, ureteral access sheath utilized, failed ureteroscopy, no or incomplete lithotripsy performed, unable to complete case due to medical or anesthetic event.

Group Type EXPERIMENTAL

Standard of care stent placement

Intervention Type DEVICE

Participants will have a stent placed per randomization assigned if there are no complications (per protocol) during ureteroscopy that excludes the participant.

Surveys

Intervention Type OTHER

All participants in the trial cohort and observational arms will be asked to complete survey instruments (evaluating their pain, quality of life, and experiences following ureteroscopy, as well as surveys evaluating their opinions and preferences around ureteral stenting, etc.).

Participants will also have routine clinical data (preoperative, perioperative, and postoperative) to be collected and analyzed for research purposes.

Observational participants - not randomized

Patients that do not consent to the randomization trial that elect to be on the observational cohort. Stent placement in the observational cohort will be decided by the surgeon intraoperatively, as per routine clinical practice.

Group Type OTHER

Surveys

Intervention Type OTHER

All participants in the trial cohort and observational arms will be asked to complete survey instruments (evaluating their pain, quality of life, and experiences following ureteroscopy, as well as surveys evaluating their opinions and preferences around ureteral stenting, etc.).

Participants will also have routine clinical data (preoperative, perioperative, and postoperative) to be collected and analyzed for research purposes.

Interventions

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Standard of care stent placement

Participants will have a stent placed per randomization assigned if there are no complications (per protocol) during ureteroscopy that excludes the participant.

Intervention Type DEVICE

No stent placement

Participants not have a stent placed per randomization assigned if there are no complications (per protocol) during ureteroscopy that excludes the participant.

Intervention Type OTHER

Surveys

All participants in the trial cohort and observational arms will be asked to complete survey instruments (evaluating their pain, quality of life, and experiences following ureteroscopy, as well as surveys evaluating their opinions and preferences around ureteral stenting, etc.).

Participants will also have routine clinical data (preoperative, perioperative, and postoperative) to be collected and analyzed for research purposes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Undergoing unilateral ureteroscopy and lithotripsy for stone disease (participants may have contralateral stones, as long as these are asymptomatic and not being treated concurrently)
* Largest stone less or equal to 10 millimeter in size as measured on abdominal x-ray, ultrasound, or computed tomography scan
* Access to means of communication with the study team (email, text messaging, and/or telephone)
* Adequate independent cognitive function and English language proficiency to complete study surveys
* Written informed consent

Exclusion Criteria

* Planned bilateral ureteroscopy
* Indwelling ureteral stent or percutaneous nephrostomy tube preoperatively in either kidney
* Anatomic abnormalities of the ipsilateral upper urinary tract (for example, horseshoe kidney, crossed fused ectopia, pelvic kidney, urinary diversion)
* Anatomic or functional solitary kidney
* Planned secondary or staged ureteroscopy
* Planned use of ureteral access sheath
* Pregnancy
* Patients who use opiate medication daily for greater than 3 months to manage a painful condition


* ureteral perforation
* unanticipated anatomic abnormality
* greater than expected bleeding
* ureteral dilation greater than 12 French
* ureteral access sheath utilized
* failed ureteroscopy
* no or incomplete lithotripsy performed
* unable to complete case due to medical or anesthetic event.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Michigan Urological Surgery Improvement Collaborative (MUSIC)

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Khurshid Ghani

Professor of Urology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Khurshid Ghani, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Arizona

Tucson, Arizona, United States

Site Status RECRUITING

UF Health Shands Hospital

Gainesville, Florida, United States

Site Status RECRUITING

Indiana University Department of Urology

Indianapolis, Indiana, United States

Site Status RECRUITING

University of Michigan Health System

Ann Arbor, Michigan, United States

Site Status RECRUITING

University of Michigan Health System

Brighton, Michigan, United States

Site Status RECRUITING

Cadillac Munson Hospital

Cadillac, Michigan, United States

Site Status RECRUITING

St. Joseph Health System Chelsea Hospital

Chelsea, Michigan, United States

Site Status RECRUITING

St. Joseph Mercy Health (Trinity)

Chelsea, Michigan, United States

Site Status RECRUITING

Henry Ford Health System

Detroit, Michigan, United States

Site Status RECRUITING

Corewell Health Buttersworth Hospital

Grand Rapids, Michigan, United States

Site Status RECRUITING

E.W Sparrow Hospital

Lansing, Michigan, United States

Site Status RECRUITING

MyMichigan Medical Center Midland

Midland, Michigan, United States

Site Status RECRUITING

Michigan Institute of Urology Town Center Ambulatory Surgery Center

Troy, Michigan, United States

Site Status RECRUITING

Monte Fiore

Brooklyn, New York, United States

Site Status RECRUITING

Mount Sinai

New York, New York, United States

Site Status RECRUITING

UNC Hospital

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Elaina Shoemaker

Role: CONTACT

734-764-3916

Sabrina Clark

Role: CONTACT

734-323-9353

Facility Contacts

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Elaina Shoemaker

Role: primary

248-704-9671

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

248-704-9671

Sabrina Clark

Role: primary

734-323-9353

Sabrina Clark

Role: primary

734-323-9353

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

248-704-9671

Sabrina Clark

Role: primary

734-323-9353

Casey Dauw, MD

Role: backup

734-936-7030

Elaina Shoemaker

Role: primary

248-704-9671

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

736-764-3916

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

734-764-3916

Elaina Shoemaker

Role: primary

734-764-3916

Blair Gallante

Role: backup

631-991-1159

Elaina Shoemaker

Role: primary

734-764-3916

References

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Becker REN, Daignault-Newton S, Shoemaker E, Sitek D, Thelus JM, Clark S, Martin-Schwarze A, Spino C, Carlozzi NE, Meurer WJ, Sales AE, Dauw CA, Ghani KR. Stent Omission after Ureteroscopy and Lithotripsy (SOUL) in the Michigan Urological Surgery Improvement Collaborative (MUSIC): study protocol for a pragmatic prospective combined randomized and observational clinical trial. Trials. 2024 Dec 4;25(1):811. doi: 10.1186/s13063-024-08587-8.

Reference Type DERIVED
PMID: 39633425 (View on PubMed)

Other Identifiers

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CER-2021C2-22856

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

HUM00234740

Identifier Type: -

Identifier Source: org_study_id

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