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NCT Number: NCT07336485

Forced Diuresis After Flexible Ureteroscopy for Medium-Sized Renal Stones

This randomized controlled clinical trial evaluated whether furosemide-assisted forced diuresis during flexible ureteroscopy reduced the residual fragment rate and improved the stone-free rate after flexible ureteroscopy for management of medium sized renal stones measuring up to 30 millimeters. Adult patients undergoing flexible ureteroscopy for renal stones 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. Stone-free status and residual fragments were assessed using non-contrast computed tomography performed four weeks after the procedure, and residual fragments were classified by fragment size. Secondary outcomes included operative time, length of hospital stay, postoperative complications, total urine output in the first 24 hours, and the need for additional treatments for 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.
  • 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. Stone-free rate on non-contrast computed tomography

    Time frame: Four weeks after flexible ureteroscopy

    Stone-free status was assessed using non-contrast computed tomography performed four weeks after the procedure. Residual fragments were classified into four grades: Grade A (no stones), Grade B (0 to 2 millimeters), Grade C (2.1 to 4 millimeters), and Grade D (greater than 4 millimeters, clinically significant residual stones).

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. Length of hospital stay

    Time frame: From end of procedure to hospital discharge (up to 7 days)

    Length of hospital stay was calculated from the day of surgery to the day of discharge.

  3. Postoperative hematuria

    Time frame: From end of procedure through 4 weeks post-procedure

    Hematuria was recorded after the procedure.

  4. 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.

  5. Postoperative pain score

    Time frame: Recovery room (PACU), postoperative day 1, and at discharge (up to 7 days)

    Postoperative pain was assessed using a numerical rating scale (NRS) from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain (higher scores = worse pain). Pain was recorded in the recovery room (PACU), on postoperative day 1 (during admission), and at discharge.

  6. Need for auxiliary treatment for clinically significant residual stones

    Time frame: Up to four weeks after flexible ureteroscopy

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

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Official study title

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

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jan 13, 2026
Registry last updated
Jan 13, 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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