Using Retrograde Intrarenal Surgery for Managing Staghorn Renal Stones.
NCT ID: NCT07342361
Last Updated: 2026-02-03
Study Results
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Basic Information
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RECRUITING
NA
100 participants
INTERVENTIONAL
2026-01-20
2026-12-01
Brief Summary
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Detailed Description
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Percutaneous nephrolithotomy (PCNL) is currently the recommended primary treatment option for staghorn renal calculi. However, the procedure has significant drawbacks, including invasiveness, postoperative bleeding, infection, prolonged hospitalization, and slow recovery. Retrograde Intrarenal Surgery (RIRS), an effective minimally invasive procedure, has become the first-line treatment for stones smaller than 2cm. With advancements in endoscopic equipment and techniques, RIRS is also being gradually utilized for the treatment of staghorn renal calculi in patients who are not suitable for PCNL.
Ureteral access sheath (UAS) is an important tool for the endourologist. Advantages of using a UAS in ureteroscopy include: ena¬bling repeated passage of the ureteroscope while mini¬mizing damage, improving the flow of irrigation fluid and visualization within the ureter, reducing operative times, reducing the costs of procedures and improving the effectiveness of surgery.
Intending to overcome the shortages of RIRS, a patented ureter access sheath with features of suction and bendable-tip is designed. The tip of the innovated ureteral access sheath can reach the target calyx along with the flexible ureteroscope.
The adjustable continuous negative pressure suction ensures sufficient irrigation speed and maintains a clear surgical field of view, while effectively removing fragmented stones and dust, and reducing the thermal energy generated by laser lithotripsy.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
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Group (1): Retrograde intrarenal surgery using a bendable tip-suction ureteral access sheath
During retrograde intrarenal surgery, an ureteral access sheath with bendable tip \& connected to suction system will be used.
Retrograde intrarenal surgery
Retrograde intrarenal surgery with using laser for management of renal staghorn stones
Group (2): Retrograde intrarenal surgery using a conventional ureteral access sheath
During retrograde intrarenal surgery, a conventional ureteral access sheath will be used.
Retrograde intrarenal surgery
Retrograde intrarenal surgery with using laser for management of renal staghorn stones
Interventions
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Retrograde intrarenal surgery
Retrograde intrarenal surgery with using laser for management of renal staghorn stones
Eligibility Criteria
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Inclusion Criteria
* Patient has a staghorn renal stone (complete or partial staghorn).
* Normal renal function tests.
* Congenital renal anomalies as horseshoe, pelvic or mal-rotated kidneys.
Exclusion Criteria
* Active or untreated urinary tract infection.
* Age under 18 years or above 70 years.
* Patient has a staghorn stone associated with other pathology which requires additional intervention, as ureteral stricture or ureteropelvic junction obstruction (UPJO).
* Pregnancy.
18 Years
70 Years
ALL
No
Sponsors
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Helwan University
OTHER
Responsible Party
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Ahmed Hassan Ahmed Hassan Elsergany
Principal Investigator
Principal Investigators
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Ahmed H Elsergany, MSc
Role: PRINCIPAL_INVESTIGATOR
Helwan University
Locations
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Faculty of medicine, Helwan University
Cairo, , Egypt
Countries
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Central Contacts
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Facility Contacts
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References
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Bai Y, Wang X, Yang Y, Han P, Wang J. Percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones up to 2 cm in patients with solitary kidney: a single centre experience. BMC Urol. 2017 Jan 18;17(1):9. doi: 10.1186/s12894-017-0200-z.
Liang H, Liang L, Lin Y, Yu Y, Xu X, Liang Z, Sheng J, Shen B. Application of tip-bendable ureteral access sheath in flexible ureteroscopic lithotripsy: an initial experience of 224 cases. BMC Urol. 2023 Nov 1;23(1):175. doi: 10.1186/s12894-023-01347-x.
Kaplan AG, Lipkin ME, Scales CD Jr, Preminger GM. Use of ureteral access sheaths in ureteroscopy. Nat Rev Urol. 2016 Mar;13(3):135-40. doi: 10.1038/nrurol.2015.271. Epub 2015 Nov 24.
Zeng G, Zhao Z, Mazzon G, Pearle M, Choong S, Skolarikos A, Denstedt J, Seitz C, Olvera Pasada D, Fiori C, Bosio A, Papatsoris A, Mendez Probst CE, Perez Fentes D, Ann Git K, Wu Q, Wiseman O, Emiliani E, Farahat Y, Ilker Gokce M, Giannakopoulos S, Goumas Kartalas I, Somani B, Knoll T, de la Rosette J, Zhong J, Vinicius Maroccolo M, Saltirov L, Chew B, Wang K, Lahme S, Giusti G, Ferretti S, Yong Cho S, Geavlete P, Cansino R, Kamphuis GM, Smith D, Matlaga BR, Ghani KD, Bernardo N, Silva AD, Ng ACF, Yang S, Gao X, Traxer O, Miernik A, Liatsikos E, Priyakant Parikh K, Duvdevani M, Celia A, Yasui T, Aquino A, Alomar M, Choonhaklai V, Erkurt B, Glass J, Sriprasad S, Osther PJ, Keeley FX Jr, Preminger GM, Cepeda Delgado M, Beltran Suarez E, Ye Z, Sarica K. European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Retrograde Intrarenal Surgery for the Management of Renal Stones. Eur Urol Focus. 2022 Sep;8(5):1461-1468. doi: 10.1016/j.euf.2021.10.011. Epub 2021 Nov 24.
Keller EX, De Coninck V, Doizi S, Traxer O. The role of ureteroscopy for treatment of staghorn calculi: A systematic review. Asian J Urol. 2020 Apr;7(2):110-115. doi: 10.1016/j.ajur.2019.10.012. Epub 2019 Dec 5.
Other Identifiers
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129-2025
Identifier Type: -
Identifier Source: org_study_id
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