The Role of Preoperative Ureteral Diameter Measurements in Predicting Difficult Access During Retrograde Intrarenal Surgery: A Retrospective Analysis of 234 Patients

December 21, 2024 updated by: Basri Cakiroglu, Hisar Intercontinental Hospital

Hisar Hospital Intercontinental

This study investigates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A retrospective analysis was conducted on 234 patients who underwent RIRS, evaluating factors such as preoperative ureteral diameters (measured at distal, iliac, and upper ureteral levels via CT scans), stone size, patient demographics, operation duration, and surgical success rates. The findings aim to determine whether ureteral diameter measurements can serve as reliable predictors for surgical challenges, ultimately improving preoperative planning and patient outcomes.

Study Overview

Status

Completed

Conditions

Detailed Description

This retrospective study evaluates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A total of 234 patients who underwent RIRS were included in the analysis. Preoperative computed tomography (CT) scans were used to measure ureteral diameters at three levels: distal ureter, iliac ureter, and upper ureter. The relationship between ureteral diameter and intraoperative access difficulty was assessed.

The study also analyzed patient demographics (age, gender, BMI), stone characteristics (size, location), operative parameters (duration, access attempts), and outcomes (surgical success and complication rates). Difficult access during RIRS was defined based on the number of attempts required to achieve successful ureteral access, need for secondary procedures, or inability to complete the planned surgery.

The primary aim was to determine whether preoperative ureteral diameter measurements can serve as predictive markers for challenging surgical access. Secondary objectives included identifying other patient or stone-related factors contributing to access difficulty and evaluating their impact on surgical outcomes. The findings may assist clinicians in preoperative planning, improving patient selection for RIRS, and optimizing intraoperative strategies to minimize complications and enhance procedural success rates.

Study Type

Observational

Enrollment (Actual)

234

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Istanbul, Turkey, 34768
        • Hisar Intercontinental Hospital
      • Istanbul, Turkey, 34768
        • Basri Cakiroglu

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adult patients (aged 18 years and older) who underwent retrograde intrarenal surgery (RIRS) for the management of kidney stones at a tertiary care center. Patients included in the study were evaluated retrospectively, with data obtained from their medical records, including preoperative imaging, intraoperative findings, and postoperative outcomes.

The population represents a diverse group in terms of age, gender, body mass index (BMI), and stone characteristics (e.g., size, location). Patients with sufficient preoperative imaging data and complete surgical records were included to ensure accurate analysis of ureteral diameter measurements and their relationship to surgical outcomes.

Description

Inclusion Criteria:

Patients aged 18 years or older. Diagnosed with kidney stones (nephrolithiasis) requiring surgical intervention. Underwent retrograde intrarenal surgery (RIRS). Available preoperative CT scans for ureteral diameter measurements. Complete medical records, including demographic, clinical, and surgical data.

Exclusion Criteria:

History of open or laparoscopic renal surgery. Presence of ureteral strictures or congenital anomalies. Patients with incomplete or missing medical records. Active urinary tract infection at the time of surgery. Pregnant or lactating individuals.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Easy Access Group
Patients with successful ureteral access on the first attempt during retrograde intrarenal surgery (RIRS).
Difficult Access Group
Patients requiring multiple attempts for ureteral access, alternative procedures, or cases where the planned surgery could not be completed due to access issues.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Predictive Value of Preoperative Ureteral Diameter for Difficult Access During RIRS
Time Frame: Intraoperative (assessed during the surgical procedure).
Evaluate the correlation between preoperative ureteral diameters (measured at distal, iliac, and upper ureteral levels via CT imaging) and the difficulty of achieving ureteral access during retrograde intrarenal surgery (RIRS).
Intraoperative (assessed during the surgical procedure).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hisar Intercontinental Hospital

Investigators

  • Principal Investigator: Basri Cakiroglu, Hisar Intercontinental Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2018

Primary Completion (Actual)

December 31, 2022

Study Completion (Actual)

December 10, 2024

Study Registration Dates

First Submitted

December 18, 2024

First Submitted That Met QC Criteria

December 18, 2024

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

December 21, 2024

Last Verified

December 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 13.12.2024. 24-12

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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