High Powered Stone Dusting vs. Fragmentation and Basketing at Time of Ureteroscopy
Kidney Stone, Ureteral Stone
About this trial
This is an interventional treatment trial for Kidney Stone
Eligibility Criteria
Inclusion Criteria:
- >18 years of age
- undergoing ureteroscopic stone extraction
- Stone size 6mm stones or greater and the location to mid ureter or higher
- Willing to sign informed consent form
- Able to read, understand, and complete patient questionnaires, and pain questionnaires
Exclusion Criteria:
- < 18 years of age
- Inability to provide informed consent
- Concomitant surgery (i.e. Percutaneous nephrolithotomy, Holmium laser enucleation of the prostate
- Solitary kidney
- Nephrocalcinosis
- Members of vulnerable patient populations
- Patients without access to a phone that can receive txt messages
Sites / Locations
- Northwestern Memorial HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
laser dusting
basketing
In the "dusting" arm, the ureteroscope will be advanced into the kidney or ureter over an access wire without an access sheath in place. The identified stone will be dusted using a 200 micron Moses laser fiber at a setting of 0.3-0.6 J and 50-120 Hz using the Moses 2.0 laser system. Stone dusting will continue until the surgeon feels the fragments are all negligible in size and would be able to pass. One small piece will be extracted for analysis and the remainder will be left to pass spontaneously. If there is no evidence of injury or swelling of the ureter at the conclusion of the case a stent will be omitted.
In the Basketing arm, a ureteral access sheath (UAS) will be placed per standard fashion. The ureteroscope will be introduced into the kidney and the stone fragmented at a setting of 0.8-1.0 J and 6-15 Hz. The resultant fragments will be basket extracted through the sheath for analysis. All fragments will be removed until no residual stone remains. At the time of UAS removal the ureter will be inspected. If there is no evidence of ureteral injury or swelling then a stent will be omitted.