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L-Citrulline Versus Tamsulosin for Medical Expulsive Therapy of Distal Ureteral Stones

25 maj 2026 uppdaterad av: Hany Fathy Badawy, MD, Beni-Suef University

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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

120

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

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Studieorter

  • Egypten
    • Beni Suweif Governorate
      • Banī Suwayf, Beni Suweif Governorate, Egypten, 02456
        • Rekrytering
        • Department of Urology- Beni-Suef University Hospitals
        • Kontakt:
        • Huvudutredare:
          • Hany F Badawy, MD
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Läkemedel: L-Citrulline
Oral L-citrulline 750 mg twice daily will be administered until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.
Aktiv komparator: 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.
Läkemedel: Tamsulosin
Oral tamsulosin 0.4 mg once daily will be administered until documented stone passage or completion of 4 weeks of therapy, whichever occurs first.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Stone Expulsion Rate Within 4 Weeks
Tidsram: Within 4 weeks after randomization
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.
Within 4 weeks after randomization

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Time to Stone Expulsion
Tidsram: From randomization up to 4 weeks
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.
From randomization up to 4 weeks
Number of Pain Episodes
Tidsram: From randomization up to 4 weeks
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.
From randomization up to 4 weeks
Analgesic Use
Tidsram: From randomization up to 4 weeks
Analgesic use will be assessed by recording the number of analgesic doses required by each participant during the follow-up period.
From randomization up to 4 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Beni-Suef University

Utredare

  • Huvudutredare: Hany F Badawy, MD, Faculty of Medicine, Beni-Suef University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

6 maj 2026

Primärt slutförande (Beräknad)

1 oktober 2026

Avslutad studie (Beräknad)

1 november 2026

Studieregistreringsdatum

Först inskickad

25 maj 2026

Först inskickad som uppfyllde QC-kriterierna

25 maj 2026

Första postat (Faktisk)

1 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

1 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

25 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • FMBSUREC05052026BadawyCIT

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

Individual participant data will not be shared because the study is an investigator-initiated single-center clinical trial and the informed consent does not include a specific plan for external individual-level data sharing. Only aggregated, de-identified study results will be reported. Any future sharing of de-identified individual participant data would require additional approval from the Research Ethics Committee.

Läkemedels- och apparatinformation, studiedokument

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Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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