"Dusting" Versus "Basketing" - Treatment Of Intrarenal Stones

Completed

Conditions studied: Kidney Calculi, Kidney Stones, Nephrolithiasis, Renal Stones

In brief

The purpose of this study is to evaluate outcomes of an established procedure for treatment of kidney stones that are present within the inner aspect of the kidney. This procedure is called flexible ureteroscopy, which involves placing a small camera through the urethra while anesthetized (asleep), up the ureter (the tube connecting kidney and bladder) and into the kidney to the kidney stone. Then, the stone is broken into tiny fragments using a small laser called a Holmium laser. While this treatment is a well-established option for treatment of these stones, there are several different techniques used to help eliminate them from the kidney. Some urologists treat the stone by a method called "active" extraction whereby the ureteroscope is passed back and forth into the kidney to remove all visible stone fragments. Others use a method called "dusting" whereby the stones are broken into tiny fragments or "dust" with the intention that achieving such a small stone size will allow the stones to pass spontaneously. There has not been a systematic and rigorous comparison of these techniques in terms of treatment outcomes. By collecting information on the success of treatment, the investigators hope to provide benchmark data for future studies of kidney stone treatment and improve the care of all patients who need surgery for their kidney stones. The investigators hypothesize that the stone free rate for renal stone(s) 5-15 mm is around 90% and that the stone clearance rate with be 20% higher in those patients that undergo complete stone fragment extraction versus those that undergo stone dusting (residual fragments \< 2mm).

Key facts

Study ID

NCT01619735

Run by

Mayo Clinic

People needed

178

Starts

2013-04-01

Expected to finish

2017-06-10

Last updated by the study team

2018-09-18

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Radiopaque renal stones above the level of the ureteropelvic junction
• Kidney stones must range up to 20 mm in size or in the case of multiple stones the conglomerate diameter (additive maximal diameter of all stones on axial imaging of computed tomography) up to 20 mm is required for inclusion
• Patient must be a suitable operative candidate for flexible ureteroscopy

You may not qualify if…

• Patients who have had prior ipsilateral upper urinary tract reconstructive procedures or history of ipsilateral ureteral stricture
• Patients who have undergone prior radiotherapy to the abdomen or pelvis and those who have a neurogenic bladder or spinal cord injury
• Pregnant subjects

Where it is running

• Mayo Clinic — Scottsdale, Arizona, United States
• UCSD — San Diego, California, United States
• James Buchanan Brady Urological Institute — Baltimore, Maryland, United States
• Massachusetts General Hospital — Boston, Massachusetts, United States
• Bellevue Hospital — New York, New York, United States
• Cleveland Clinic — Cleveland, Ohio, United States
• Ohio State University — Columbus, Ohio, United States
• Vanderbilt University School of Medicine — Nashville, Tennessee, United States
• University of British Columbia — Vancouver, British Columbia, Canada

Full record on ClinicalTrials.gov

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