Supine vs. Prone PCNL for Large Renal Stones: A Randomized Trial in Yemen.

June 3, 2026 updated by: Haitham Mohammed Jowah, Sana'a University

Comparative Evaluation of Early Postoperative Complications, Cost-Effectiveness, and Patient-Centered Outcomes Following Supine and Prone Standard Percutaneous Nephrolithotomy (PCNL): A Randomized Controlled Trial

The goal of this clinical trial is to compare the safety, cost-effectiveness, and patient recovery of two different surgical positions for percutaneous nephrolithotomy (PCNL) in adults aged 18 to 70 years who have kidney stones larger than 2 cm. The main questions it aims to answer are:

  • Does the supine (lying on the back) surgical position result in fewer early postoperative complications than the traditional prone (lying on the stomach) position?
  • Does the supine position reduce the total surgery time, direct hospital costs, and postoperative pain?

Researchers will compare patients assigned to undergo PCNL in the supine position to those assigned to the prone position to see if the supine approach offers a safer, more cost-effective, and more comfortable recovery.

Participants will:

  • Undergo standard PCNL surgery to remove their kidney stones in either the supine or prone position.
  • Have their pain levels, surgery time, and any early surgical complications monitored during their hospital stay.
  • Complete brief questionnaires regarding their overall surgical satisfaction and quality of life at 1 month and 3 months after the procedure.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

140

Phase

  • Not Applicable

Contacts and Locations

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

Study Contact

  • Name: Haitham M Jowah, Lecturer
  • Phone Number: +967774831058
  • Email: h.jowah@su.edu.ye

Study Contact Backup

Study Locations

  • Yemen
      • Sanaa, Yemen, 13078
        • Al-Kuwait University Hospital
        • Contact:

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

Description

Inclusion Criteria:

  • Patients aged 18-70 years.
  • Diagnosis of solitary or multiple renal stones with a cumulative diameter greater than 2 cm, confirmed by imaging (CT KUB).
  • Patients eligible for standard PCNL (24-30 Fr).
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Willingness and ability to provide informed consent.

Exclusion Criteria:

  • Patients with active urinary tract infection (UTI) not responding to antibiotics.
  • Patients with bleeding diathesis or on anticoagulant therapy that cannot be safely discontinued.
  • Patients with anatomical abnormalities of the kidney or urinary tract that preclude standard PCNL.
  • Pregnant women.
  • Patients with severe cardiopulmonary disease where general anesthesia or prolonged surgical positioning is contraindicated.
  • Patients with a history of previous ipsilateral renal surgery.
  • Patients unwilling or unable to comply with follow-up protocols.

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Supine PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the supine position.
Procedure: Supine Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the supine position using a standard 24-30 Fr tract.
Active Comparator: Prone PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the conventional prone position.
Procedure: Prone Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the traditional prone position using a standard 24-30 Fr tract.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence and Severity of Early Postoperative Complications
Time Frame: Up to 30 days post-surgery
Complications will be assessed and classified using the Modified Clavien-Dindo Classification system. The scale ranges from Grade I (minor deviation from normal postoperative course) to Grade V (death of the patient). Lower grades indicate a better outcome.
Up to 30 days post-surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Operative Time
Time Frame: Intraoperative (Day 0)
Total duration of the surgical procedure, measured continuously from the initial skin incision to the final skin closure, recorded in minutes.
Intraoperative (Day 0)
Direct Hospitalization Costs
Time Frame: From hospital admission to hospital discharge (typically 1 to 7 days)
Total direct medical costs associated with the procedure, calculated as the sum of disposable medical supply costs and hospital stay duration costs. Measured in Yemeni Rials (YER).
From hospital admission to hospital discharge (typically 1 to 7 days)
Postoperative Pain Score
Time Frame: At 6 hours, 12 hours, and 24 hours post-surgery
Postoperative pain will be evaluated using the Visual Analog Scale. The scale ranges from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate a better outcome (less postoperative pain).
At 6 hours, 12 hours, and 24 hours post-surgery
Health-Related Quality of Life (HRQoL)
Time Frame: At 1 month and 3 months post-surgery
Measured using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. The utility index score will be calculated using the Kingdom of Saudi Arabia value set, ranging from -0.683 (worst possible health state) to 1.000 (full health), where higher scores indicate a better outcome (better health-related quality of life).
At 1 month and 3 months post-surgery
Patient Satisfaction Score
Time Frame: At 30 days post-surgery
Overall patient satisfaction with the surgical experience, anesthetic process, and early recovery will be measured using a 5-point Likert-type satisfaction scale. The scale ranges from 1 (highly dissatisfied) to 5 (highly satisfied), where higher scores indicate a better outcome (greater patient satisfaction).
At 30 days post-surgery

Collaborators and Investigators

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

Sponsor

Sana'a University

Investigators

  • Principal Investigator: Waleed M Al-Ata, M.B.B.Ch, Al-Kuwait University Hospital
  • Study Director: Khaled M Al-Kohlany, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
  • Study Chair: Abualgaith A Alkholany, MD, Al-Kuwait University 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 (Estimated)

June 1, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

May 31, 2026

First Submitted That Met QC Criteria

May 31, 2026

First Posted (Actual)

June 4, 2026

Study Record Updates

Last Update Posted (Actual)

June 5, 2026

Last Update Submitted That Met QC Criteria

June 3, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PCNL-SANA-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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