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Transurethral Versus Percutaneous Cystolithotripsy for Bladder Stones in Adults

3. september 2026 oppdatert av: Mohamed Sayed Ahmed Aboliela, Assiut University

Transurethral Versus Percutaneous Cystolithotripsy for the Management of Bladder Stones in Adults: A Prospective Randomized Comparative Study

This study evaluates and compares two minimally invasive surgical approaches for treating bladder stones in adult patients: transurethral cystolithotripsy (TUCL) and percutaneous cystolithotripsy (PCCL).

Urinary bladder stones are commonly managed using endoscopic techniques to avoid the morbidity of open surgery. TUCL accesses the bladder through the natural urinary channel (urethra), whereas PCCL accesses the bladder directly through a small puncture in the lower abdomen above the pubic bone. While both approaches are effective, comparative data in adult populations remain limited.

Eligible participants are randomly assigned to receive either TUCL or PCCL. The primary goal is to compare stone clearance rates and operative times between the two procedures. Secondary objectives include comparing surgical complication rates, duration of postoperative urinary catheterization, and length of hospital stay.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

50

Fase

  • Ikke aktuelt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Adult patients aged 18 years or older
  • Diagnosed with single or multiple urinary bladder stones
  • Stone diameter between 1 and 4 cm at its largest diameter or cumulative stone diameter
  • Candidates for both transurethral and percutaneous endoscopic treatment modalities

Exclusion Criteria:

  • Active urinary tract infection (UTI)
  • Uncorrected coagulopathy or bleeding disorders
  • Known urethral stricture or significant urethral pathology precluding safe transurethral instrumentation
  • History of bladder augmentation, major lower abdominal surgery, or pelvic radiotherapy
  • Concomitant bladder tumor or suspected bladder neoplasm
  • Stone located within a bladder diverticulum or within a contracted bladder
  • Requiring concomitant urological procedures during the same operative session (e.g., transurethral resection of the prostate [TURP] or lower ureteric stone extraction)
  • Urethral stones pushed back into the bladder
  • Refusal to participate in the study

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Group A: Transurethral Cystolithotripsy (TUCL)
Participants undergo transurethral cystolithotripsy under spinal or general anesthesia. A rigid cystoscope is introduced through the urethra under direct vision. Bladder calculi are visualized and fragmented using a Mauermayer stone punch and/or pneumatic lithotripter via a semirigid ureteroscope. Stone fragments are evacuated using an Ellik evacuator and/or grasping forceps. Stone clearance and mucosal integrity are confirmed by cystoscopy, followed by insertion of a two-way urethral Foley catheter.
Fremgangsmåte: Transurethral Cystolithotripsy
Under spinal or general anesthesia, a rigid cystoscope is introduced transurethrally under direct vision. Bladder calculi are visualized and fragmented using a Mauermayer stone punch and/or pneumatic lithotripter via a semirigid ureteroscope according to stone size and consistency. Stone fragments are evacuated using an Ellik evacuator and/or grasping forceps. Complete clearance and mucosal integrity are confirmed by cystoscopy, followed by insertion of a two-way urethral Foley catheter.
Aktiv komparator: Group B: Percutaneous Cystolithotripsy (PCCL)
Participants undergo percutaneous cystolithotripsy under spinal or general anesthesia. The bladder is filled retrogradely with 300-400 cc of sterile irrigation fluid via cystoscopy. Under ultrasound and cystoscopic guidance, a midline suprapubic puncture is performed with an 18G needle, followed by guidewire insertion, fascial dilation, and placement of a 30 F Amplatz sheath. Stones are fragmented with a pneumatic lithotripter via a 26 F nephroscope and extracted with grasping forceps. Postoperative drainage includes a urethral Foley catheter (with or without a suprapubic catheter).
Fremgangsmåte: Percutaneous Cystolithotripsy
Under spinal or general anesthesia, the bladder is distended retrogradely with 300-400 cc sterile irrigation fluid via cystoscopy. Under combined ultrasound and cystoscopic guidance, a midline suprapubic percutaneous puncture is executed using an 18G needle, followed by guidewire placement, tract dilation, and insertion of a 30 F Amplatz working sheath. A 26 F rigid nephroscope is introduced, and calculi are fragmented using a pneumatic lithotripter and removed with grasping forceps. A urethral Foley catheter is placed postoperatively, with or without a suprapubic tube based on intraoperative findings.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Stone-Free Rate
Tidsramme: 1 day
Stone-free status is defined as complete stone clearance or presence of clinically insignificant residual fragments (CIRF) <= 2 mm confirmed by direct endoscopic inspection.
1 day

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Assiut University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. oktober 2028

Studiet fullført (Antatt)

1. november 2028

Datoer for studieregistrering

Først innsendt

3. september 2026

Først innsendt som oppfylte QC-kriteriene

3. september 2026

Først lagt ut (Faktiske)

9. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • TUCL vs PCCL for Bladder Stone

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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