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L-Citrulline Versus Tamsulosin for Medical Expulsive Therapy of Distal Ureteral Stones
L-Citrulline Versus Tamsulosin for Medical Expulsive Therapy of Distal Ureteral Stones: A Prospective Randomized Study
This study will compare L-citrulline and tamsulosin as medical expulsive therapy for adults with single distal ureteral stones.
Eligible participants with a single distal ureteral stone measuring 5 to 10 mm will be randomly assigned to receive either oral L-citrulline 750 mg twice daily or oral tamsulosin 0.4 mg once daily. Treatment will continue until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
Participants will be followed weekly for up to 4 weeks. The main outcome is stone expulsion within 4 weeks. The study will also assess time to stone expulsion, pain episodes, analgesic use, need for additional intervention, and adverse events.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
This is a prospective, randomized, controlled trial conducted at the outpatient Urology Clinic, Beni-Suef University Hospital.
The study will include adult patients aged 18 to 60 years with a single distal ureteral stone measuring 5 to 10 mm, normal renal function, and controlled pain. Patients with fever or active urinary tract infection, severe hydronephrosis, solitary kidney, pregnancy, previous ureteric surgery, multiple stones, or an indication for urgent surgical intervention will be excluded.
Eligible participants will be randomized in a 1:1 ratio to one of two treatment groups. The L-citrulline group will receive oral L-citrulline 750 mg twice daily. The tamsulosin group will receive oral tamsulosin 0.4 mg once daily. Treatment will be discontinued upon stone passage or after completion of 4 weeks of therapy, whichever occurs first. Both groups will receive standard supportive care, including analgesics as needed, hydration advice, and use of a stone strainer.
Participants will be evaluated weekly for 4 weeks. Follow-up assessments will include symptom review, pain assessment using the Visual Analog Scale, documentation of pain episodes, analgesic requirements, adverse event monitoring, and imaging assessment using ultrasound with or without KUB, with low-dose computed tomography when clinically needed.
The primary outcome is stone expulsion rate within 4 weeks. Stone expulsion will be confirmed by patient-reported stone passage with stone capture, or by absence of the stone on follow-up imaging. Secondary outcomes include time to stone expulsion, number of pain episodes, analgesic use, need for additional intervention such as ureteroscopy or ureteral stenting, and adverse events.
Studietype
Inschrijving (Geschat)
Fase
- Fase 2
Contacten en locaties
Studiecontact
- Naam: Hany F Badawy, MD
- Telefoonnummer: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
Studie Contact Back-up
- Naam: Ahmed Gmal, Md
- Telefoonnummer: +20 11 18206022
- E-mail: Drhanyfathy86@GMAIL.COM
Studie Locaties
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Beni Suweif Governorate
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Banī Suwayf, Beni Suweif Governorate, Egypte, 02456
- Werving
- Department of Urology- Beni-Suef University Hospitals
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Contact:
- Hany F Badawy, MD
- Telefoonnummer: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
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Hoofdonderzoeker:
- Hany F Badawy, MD
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Contact:
- Mahmoud Abdallah, Md
- Telefoonnummer: +20 11 55361979
- E-mail: Mahmoud.abdalla@med.bsu.edu.eg
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Adults aged 18 to 60 years.
- Single distal ureteral stone.
- Stone size 5 to 10 mm.
- Normal renal function.
- Controlled pain.
- Willingness to comply with follow-up for 4 weeks.
- Written informed consent.
Exclusion Criteria:
- Fever or active urinary tract infection.
- Severe hydronephrosis.
- Solitary kidney.
- Pregnancy.
- Previous ureteric surgery.
- Multiple ureteral stones.
- Indication for urgent surgical intervention.
- Known hypersensitivity or contraindication to L-citrulline or tamsulosin.
- Inability to complete follow-up.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: L-Citrulline Plus Tamsulosin Placebo
Participants will receive oral L-citrulline 750 mg twice daily plus a matched tamsulosin placebo once daily.
Treatment will continue until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
Standard supportive care will be provided as needed.
|
Oral L-citrulline 750 mg twice daily will be administered until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
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Actieve vergelijker: Tamsulosin Plus L-Citrulline Placebo
Participants will receive oral tamsulosin 0.4 mg once daily plus a matched L-citrulline placebo twice daily.
Treatment will continue until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
Standard supportive care will be provided as needed.
|
Oral tamsulosin 0.4 mg once daily will be administered until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Stone Expulsion Rate Within 4 Weeks
Tijdsspanne: Within 4 weeks after randomization
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Stone expulsion rate will be defined as the proportion of randomized participants with confirmed stone passage within 4 weeks.
Stone expulsion will be confirmed by patient-reported stone passage with stone capture, or by absence of the ureteral stone on follow-up imaging.
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Within 4 weeks after randomization
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Time to Stone Expulsion
Tijdsspanne: From randomization up to 4 weeks
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Time to stone expulsion will be defined as the number of days from randomization to confirmed stone passage.
Stone passage will be confirmed by patient-reported stone passage with stone capture, or by absence of the ureteral stone on follow-up imaging.
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From randomization up to 4 weeks
|
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Number of Pain Episodes
Tijdsspanne: From randomization up to 4 weeks
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The number of renal colic pain episodes reported by each participant during the follow-up period will be recorded and compared between the study groups.
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From randomization up to 4 weeks
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Analgesic Use
Tijdsspanne: From randomization up to 4 weeks
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Analgesic use will be assessed by recording the number of analgesic doses required by each participant during the follow-up period.
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From randomization up to 4 weeks
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Hany F Badawy, MD, Faculty of Medicine, Beni-Suef University
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Mannelijke urogenitale ziekten
- Berekeningen
- Pathologische aandoeningen, anatomisch
- Urologische ziekten
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Urinewegen
- Ureterale ziekten
- Pathologische aandoeningen, tekenen en symptomen
- Ureterolithiase
- Ureterale Calculi
- Urolithiase
- Aminozuren, peptiden en eiwitten
- Zwavelverbindingen
- Organische chemicaliën
- Koolwaterstoffen
- Koolwaterstoffen, cyclisch
- Koolwaterstoffen, aromatisch
- Amides
- Aminozuren
- Benzeenderivaten
- Aminozuren, diamino
- Benzenulfonamides
- Sulfonamides
- Sulfonen
- Tamsulosine
- Citrulline
Andere studie-ID-nummers
- FMBSUREC05052026BadawyCIT
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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