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Intravesical Bupivacaine on Post-Operative Ureteroscopy Pain

Phase 2
Recruiting
Conditions
Nephrolithiasis
Interventions
Other: Normal saline
Registration Number
NCT06635889
Lead Sponsor
University of Chicago
Brief Summary

Post-operative pain and lower urinary tract symptoms are common following ureteroscopy in the treatment of stone disease. The use of bupivacaine as a topical pain medication is used routinely for other urologic procedures, however, to date there are no studies that have rigorously investigated the effect of instilling bupivacaine in the bladder following ureteroscopy.

This is a randomized study that will investigate the effect of instilling bupivacaine in the bladder following routine ureteroscopy, laser lithotripsy and ureteral stenting in the treatment of stone disease. Compared to a placebo of Normal Saline, our study hypothesizes that administration of topical bupivacaine in the bladder will decrease post-operative pain and lower urinary tract symptoms while improving quality of life in the early post-operative period.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
116
Inclusion Criteria
  • Provision of signed and dated informed consent form
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Male or female, aged ≥ 18 years old.
  • Diagnosis of nephrolithiasis planned for flexible or semi-rigid ureteroscopy in the treatment of stone disease with ureteral stenting.
Exclusion Criteria
  • Foley catheterization
  • History of allergy to bupivacaine
  • Antegrade ureteroscopy
  • Transplant or ectopic kidney
  • Ureteral or bladder reconstruction
  • Pregnancy (which is a contraindication to elective ureteroscopy)
  • Dialysis
  • Surgical complication (significant bleeding, ureteral perforation, significant urothelial damage)
  • Suspicion of untreated urinary tract infection
  • History of pelvic radiation
  • Neurologic disease with a diagnosis of neurogenic bladder dysfunction
  • History of chronic pain (fibromyalgia, interstitial cystitis, opioid abuse)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebo of 50 ml of Normal SalineNormal saline-
50 ml of 0.25% bupivacaineBupivacaine-
Primary Outcome Measures
NameTimeMethod
Post-operative pain as determined by the score on a Visual Analog Scale (VAS) upon emergence from anesthesiaAt 30 minutes post-emergence, 60 minutes post-emergence, 6 hours post-emergence and on post-operative day 1

Pain will be assessed using a Likert 10-point scale upon emergence from anesthesia in the recovery room, post-emergence 30 minutes, 60 minutes post-emergence and 6 and 24 hours post-emergence. These types of scales are commonly used to measure post operative pain both in anesthesia and in endourology

Secondary Outcome Measures
NameTimeMethod
Time to dischargeFrom Baseline to post- operative day 5
Milliequivalent of morphine consumedFrom Baseline to post- operative day 5
Number of bladder spasmsFrom Baseline to post- operative day 5
Time to voidFrom Baseline to post- operative day 5
Quality of life based on the Ureteral Stent Symptom Questionnaire (USSQ)From Baseline to post- operative day 5

A validated tool of 38 questions that assesses the symptoms and quality of life impact of ureteral stents.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Adult Function Short FormFrom Baseline to post- operative day 5
Adverse eventsFrom Baseline to post- operative day 5

Trial Locations

Locations (1)

The University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

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