Optimal Drainage After Flexible Ureterorenoscopy; Prospective Assessment of Perioperative Outcomes and Health-Related Quality of Life Through a Randomized Controlled Trial

Not Applicable

Active, not recruiting

Interventions: Procedure: Flexible ureteroscopy for renal calculi less than 20 mm

Brief Summary: Flexible ureterorenoscopy (FURS) is now recommended for the treatment of kidney stones smaller than 20 mm, as an alternative to extracorporeal shock wave lithotripsy (ESWL) and in combination with percutanous nephrolithotomy (PCNL) for stones larger than 20 mm. At the end of the operation, a ureteral drainage is put in place for the treatment of residual fragments and the inflammation following the ureteroscopy. It helps prevent obstructive symptoms and the development of strictures.

Drainage is done either by a ureteral catheter or by a double J stent. In the literature, while drainage after ureteroscopy is recommended, the criteria for choosing between these two options are not clearly defined.

The objective of this study will be to assess whether the type of postoperative drainage after URS for kidney stones can influence the perioperative outcomes and health-related quality of life.

Detailed Description: Flexible ureterorenoscopy (FURS) is now recommended for the treatment of kidney stones smaller than 20 mm, as an alternative to extracorporeal shock wave lithotripsy (ESWL) and in combination with percutanous nephrolithotomy (PCNL) for stones larger than 20 mm. At the end of the operation, a ureteral drainage is put in place for the treatment of residual fragments and the inflammation following the ureteroscopy. It helps prevent obstructive symptoms and the development of strictures.

Drainage is done either by a ureteral catheter or by a double J stent. In the literature, while drainage after ureteroscopy is recommended, the criteria for choosing between these two options are not clearly defined.

The objective of this study will be to assess whether the type of postoperative drainage after URS for kidney stones can influence the perioperative outcomes and health-related quality of life.

Recruitment & Eligibility

Inclusion Criteria

1- Adult patients (aged >18 years) 2- Undergo unilateral uncomplicated retrograde intrarenal surgery (RIRS) using flexible ureterorenoscopy.

Exclusion Criteria

Residual ureteral or renal stones after the procedure as documented by the surgeon
Patients who will need auxiliary procedures (ESWL , re-FURS or PCNL)
Preoperative febrile UTI
pregnancy or breastfeeding
Bilateral ureteroscopic surgery
Single kidney
Chronic kidney disease
Cardiovascular or cerebrovascular disease
Hepatic dysfunction
Other acute medical conditions as acute gastroenteritis, osetoarthritis that might influence the patient QoL

Arm && Interventions

Group	Intervention	Description
Ureteral catheter	Flexible ureteroscopy for renal calculi less than 20 mm	This group will receive ureteral catheter for 2 days after the procedure
Indwelling double J stent	Flexible ureteroscopy for renal calculi less than 20 mm	This group will receive indwelling double J stent for 2-4 weeks after the procedure

Primary Outcome Measures

Name	Time	Method
Stone free rate	12 weeks after the procedure	presence of residual fragments on non contrast computed tomography

Secondary Outcome Measures

Name	Time	Method
perioperative complications	First 3 days postoperative	perioperative complications after the procedure
Postoperative pain by visual analogue scale	first 24 hours postoperatively	Visual analogue scale will be assessed postoperative

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