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NCT Number: NCT07336485

Impact of Forced Diuresis on the Residual Fragment Rate After Flexible Ureteroscopy for Management of Renal Stones

This randomized controlled clinical trial evaluated whether furosemide-assisted forced diuresis during flexible ureteroscopy reduced the residual fragment rate and improved stone clearance in patients with renal stones measuring up to 30 millimeters. Adult patients undergoing flexible ureteroscopy were randomized into two parallel groups: an experimental group that received intravenous furosemide during the procedure and a control group that received standard perioperative and postoperative care without furosemide. Residual stone fragments were assessed using low-dose non-contrast computed tomography on postoperative day 1 and at 6 weeks after the procedure. The primary outcome was the proportion of patients with residual stone fragments greater than 2 millimeters on postoperative day 1. Secondary outcomes included the proportion of patients with residual stone fragments greater than 2 millimeters at 6 weeks, operative time, postoperative complications, and the need for auxiliary treatment for clinically significant residual stones.

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Key information

Conditions

Kidney Stones Calculi Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Kidney Calculi Kidney Diseases Male Urogenital Diseases Nephrolithiasis Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Urinary Calculi Urogenital Diseases Urolithiasis Urologic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ain Shams University Hospitals (Urology Department)

Cairo, Cairo Governorate, 11511, Egypt

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patients aged 18 years or older.
  • Patients who underwent flexible ureteroscopy for renal stones measuring 30 millimeters or less.

Exclusion criteria

  • Patients with active urinary tract infection.
  • Patients with a history of previous open renal surgery or renal trauma.
  • Patients with contraindications to anesthesia, such as severe cardiac disease, uncontrolled diabetes mellitus, or severe coagulation disorder.
  • Patients with severe renal impairment, defined as an estimated glomerular filtration rate less than 30 milliliters per minute per 1.73 square meters.
  • Known Ureteric stricture and pelvi-ureteric junction obstruction
  • Patients with a single kidney.
  • Patients with contraindications to furosemide administration.
  • Patients with congenital renal anomalies.

Treatment and study plan

Furosemide

Drug

Intravenous furosemide was administered as a total dose of 40 milligrams during the procedure, divided into 20 milligrams given 5 minutes after induction of anesthesia and 20 milligrams given 30 minutes after the start of the procedure.

Standard Care After Flexible Ureteroscopy Without Furosemide

Other

Participants received standard perioperative and postoperative management after flexible ureteroscopy without administration of furosemide or any other diuretic medication.

Primary outcomes

  1. Proportion of patients with residual stone fragments greater than 2 mm

    Time frame: Postoperative day 1 after flexible ureteroscopy

    Residual stone fragments were assessed using low-dose non-contrast computed tomography (CT) performed on postoperative day 1. The outcome was reported as the proportion of patients with one or more residual renal stone fragments measuring greater than 2 mm.

Secondary outcomes

  1. Operative time

    Time frame: During procedure

    Operative time was calculated from insertion of the ureteroscope into the urethra until completion of ureteral stent placement.

  2. Postoperative urinary tract infection

    Time frame: Within 7 days post-procedure

    Postoperative urinary tract infection was assessed within seven days after the procedure using fever with urinary symptoms and or a positive urine culture with significant bacteriuria.

  3. Need for auxiliary treatment for clinically significant residual stones

    Time frame: Up to 6 weeks after flexible ureteroscopy

    The need for auxiliary treatment for clinically significant residual stones was recorded, including extracorporeal shock wave lithotripsy or repeat ureteroscopy.

  4. Proportion of patients with residual stone fragments greater than 2 mm at 6 weeks

    Time frame: 6 weeks after flexible ureteroscopy

    Residual stone fragments were assessed using low-dose non-contrast computed tomography (CT) performed 6 weeks after flexible ureteroscopy. The outcome was reported as the proportion of patients with one or more residual renal stone fragments measuring greater than 2 mm.

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 13, 2026
Registry last updated
Aug 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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