- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT07617948
Intravesical Aminophylline for Urgent Ureteral Stenting in Acute Calculous Anuria
Intravesical Aminophylline-Assisted Urgent Retrograde Ureteral Stenting for Acute Calculous Anuria: A Prospective Randomized Controlled Trial
Acute calculous anuria is a urological emergency caused by ureteral stone obstruction in a solitary functioning kidney or bilateral ureteral obstruction. Urgent decompression of the upper urinary tract is required to restore urine drainage and prevent further renal impairment.
This prospective randomized double-blind controlled trial will evaluate whether intravesical aminophylline can facilitate urgent retrograde ureteral stenting in adult patients with acute calculous anuria due to ureteral stones. Eligible patients will be randomly assigned to receive either intravesical aminophylline diluted in normal saline or placebo saline before attempted retrograde Double-J ureteral stent placement.
The primary outcome is technical success, defined as successful placement of a Double-J ureteral stent across the obstructing stone without the need for percutaneous nephrostomy. Secondary outcomes include stenting time, intraoperative complications, renal function recovery, postoperative pain, analgesic requirement, and the need for alternative drainage.
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
This is a prospective, randomized, double-blind, controlled trial conducted at the Department of Urology, Beni-Suef University Hospital.
The study will include adult patients aged 18 years or older presenting with acute calculous anuria due to ureteral stone obstruction in a solitary functioning kidney or bilateral ureteral obstruction. Obstruction will be confirmed by pelvi-abdominal ultrasound and computed tomography of the urinary tract. Eligible patients will have clinical and laboratory evidence of acute renal impairment, including oliguria or anuria and elevated serum creatinine.
After eligibility assessment and informed consent, participants will be randomly allocated in a 1:1 ratio to one of two groups.
Participants in the aminophylline group will receive intravesical instillation of 250 mg aminophylline diluted in normal saline to a total volume of 160 mL. Participants in the control group will receive placebo intravesical instillation using normal saline with the same total volume. The study solution will be prepared by a nurse who is not involved in the operation to maintain blinding of the patient and the operating surgeon.
Under general or spinal anesthesia, the patient will be placed in the lithotomy position. A cystoscope will be introduced and the bladder will be emptied. The assigned intravesical solution will then be instilled into the bladder and retained for 5 minutes before proceeding with retrograde ureteral stenting. Under fluoroscopic guidance, a guidewire will be advanced through the ureteric orifice in an attempt to bypass the obstructing ureteral stone. If successful, a Double-J ureteral stent will be advanced over the guidewire and positioned across the obstruction.
The primary endpoint is technical success of retrograde ureteral stenting, defined as successful placement of the Double-J stent across the obstructing stone without the need for percutaneous nephrostomy. Secondary endpoints include time required for successful stent placement, intraoperative complications, serum creatinine changes at 24, 48, and 72 hours after decompression, postoperative pain score, analgesic requirement, and the need for alternative drainage after failed retrograde stenting.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Vaihe 2
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Hany F Badawy, MD
- Puhelinnumero: +201149525028
- Sähköposti: HANYFATHY86@GMAIL.COM
Tutki yhteystietojen varmuuskopiointi
- Nimi: Mahmoud Abdallah, MD
- Puhelinnumero: +201211874080
- Sähköposti: Drhanyfathy86@GMAIL.COM
Opiskelupaikat
-
-
Beni Suweif Governorate
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Banī Suwayf, Beni Suweif Governorate, Egypti
- Rekrytointi
- Department of Urology- Beni-Suef University Hospitals
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Ottaa yhteyttä:
- Hany F Badawy, MD
- Puhelinnumero: +201149525028
- Sähköposti: HANYFATHY86@GMAIL.COM
-
Ottaa yhteyttä:
- Mahmoud Abdallah, MD
- Puhelinnumero: +201211874080
- Sähköposti: Drhanyfathy86@GMAIL.COM
-
Päätutkija:
- Hany F Badawy, MD
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Patients aged 18 years or older.
- Diagnosis of acute calculous anuria due to ureteral stone obstruction in a solitary functioning kidney.
- Obstruction confirmed by pelvi-abdominal ultrasound and computed tomography of the urinary tract.
- Clinical and laboratory evidence of acute renal impairment, including oliguria or anuria and serum creatinine >2 mg/dL.
- Ability to provide written informed consent.
Exclusion Criteria:
- Known hypersensitivity to aminophylline, theophylline, or other methylxanthines.
- Evidence of active urinary tract infection or urosepsis.
- Previous history of ureteral stricture or major urinary tract reconstructive surgery.
- Hemodynamic instability requiring immediate life-saving measures before urological intervention.
- Pregnancy.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Nelinkertaistaa
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Intravesical Aminophylline
Participants will receive intravesical instillation of 250 mg aminophylline diluted with normal saline to a total volume of 160 mL.
The solution will be retained in the bladder for 5 minutes before attempted urgent retrograde Double-J ureteral stent placement.
|
Aminophylline 250 mg diluted with normal saline to a total intravesical instillation volume of 160 mL.
The solution will be retained in the bladder for 5 minutes before urgent retrograde Double-J ureteral stent placement.
|
|
Placebo Comparator: Placebo Saline
Participants will receive intravesical placebo instillation using normal saline to a total volume of 160 mL.
The solution will be retained in the bladder for 5 minutes before attempted urgent retrograde Double-J ureteral stent placement.
|
Placebo intravesical instillation using normal saline to a total volume of 160 mL.
The solution will be retained in the bladder for 5 minutes before urgent retrograde Double-J ureteral stent placement.
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Technical Success of Retrograde Double-J Ureteral Stent Placement
Aikaikkuna: During the index urgent retrograde stenting procedure
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Technical success will be defined as successful placement of a Double-J ureteral stent across the obstructing ureteral stone during the initial urgent retrograde stenting procedure without the need for percutaneous nephrostomy.
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During the index urgent retrograde stenting procedure
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Retrograde Stenting Attempt Time
Aikaikkuna: During the index urgent retrograde stenting procedure
|
Time will be measured in minutes from the start of the retrograde stenting attempt after the 5-minute intravesical dwell time until successful final Double-J stent positioning or the decision to stop the retrograde attempt because of technical failure.
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During the index urgent retrograde stenting procedure
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Intraoperative Complication Rate
Aikaikkuna: During the index urgent retrograde stenting procedure
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Proportion of participants who experience intraoperative procedure-related complications, including ureteral mucosal injury, ureteral perforation, bleeding, guidewire false passage, or other procedure-related adverse events.
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During the index urgent retrograde stenting procedure
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Serum Creatinine Change During the First 72 Hours After Decompression
Aikaikkuna: Baseline, 24 hours, 48 hours, and 72 hours after decompression
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Serum creatinine will be measured before decompression and at 24, 48, and 72 hours after the procedure to assess early renal function recovery.
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Baseline, 24 hours, 48 hours, and 72 hours after decompression
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Postoperative Pain Score During the First 24 Hours
Aikaikkuna: Every 4 hours during the first 24 hours postoperatively
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Postoperative pain will be assessed using a 10-point Visual Analog Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain.
Scores will be recorded every 4 hours during the first 24 hours after recovery from anesthesia.
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Every 4 hours during the first 24 hours postoperatively
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: Hany F Badawy, MD, Beni-Suef University
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
- Urogenitaaliset sairaudet
- Miesten urogenitaaliset sairaudet
- Calculi
- Patologiset tilat, anatomiset
- Munuaissairaudet
- Urologiset sairaudet
- Naisten virtsa- ja sukupuolielinten sairaudet
- Naisten virtsa- ja sukupuolielinten sairaudet ja raskauden komplikaatiot
- Virtsakivitauti
- Virtsakivi
- Munuaisten vajaatoiminta
- Virtsaputken sairaudet
- Patologiset tilat, merkit ja oireet
- Ureterolithiaasi
- Akuutti munuaisvaurio
- Virtsaputken kivi
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