- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne 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.
Przegląd badań
Status
Interwencja / Leczenie
Szczegółowy opis
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.
Typ studiów
Zapisy (Szacowany)
Faza
- Faza 2
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Hany F Badawy, MD
- Numer telefonu: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
Kopia zapasowa kontaktu do badania
- Nazwa: Mahmoud Abdallah, MD
- Numer telefonu: +201211874080
- E-mail: Drhanyfathy86@GMAIL.COM
Lokalizacje studiów
-
-
Beni Suweif Governorate
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Banī Suwayf, Beni Suweif Governorate, Egipt
- Rekrutacyjny
- Department of Urology- Beni-Suef University Hospitals
-
Kontakt:
- Hany F Badawy, MD
- Numer telefonu: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
-
Kontakt:
- Mahmoud Abdallah, MD
- Numer telefonu: +201211874080
- E-mail: Drhanyfathy86@GMAIL.COM
-
Główny śledczy:
- Hany F Badawy, MD
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Poczwórny
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Eksperymentalny: 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.
|
|
Komparator placebo: 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.
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Technical Success of Retrograde Double-J Ureteral Stent Placement
Ramy czasowe: During the index urgent retrograde stenting procedure
|
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.
|
During the index urgent retrograde stenting procedure
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Retrograde Stenting Attempt Time
Ramy czasowe: 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.
|
During the index urgent retrograde stenting procedure
|
|
Intraoperative Complication Rate
Ramy czasowe: During the index urgent retrograde stenting procedure
|
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
Ramy czasowe: Baseline, 24 hours, 48 hours, and 72 hours after decompression
|
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
Ramy czasowe: Every 4 hours during the first 24 hours postoperatively
|
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
|
Współpracownicy i badacze
Sponsor
Śledczy
- Główny śledczy: Hany F Badawy, MD, Beni-Suef University
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby układu moczowo-płciowego
- Choroby układu moczowo-płciowego u mężczyzn
- Rachunek różniczkowy
- Stany patologiczne, anatomiczne
- Choroby nerek
- Choroby Urologiczne
- Choroby układu moczowo-płciowego kobiet
- Choroby układu moczowo-płciowego kobiet i powikłania ciąży
- Kamica moczowa
- Kamica moczowa
- Niewydolność nerek
- Choroby moczowodu
- Stany patologiczne, oznaki i objawy
- Kamica moczowodowa
- Ostre uszkodzenie nerek
- Kamica moczowodu
Inne numery identyfikacyjne badania
- FMBSUREC07042026Ahmed
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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