Treatment of Upper Urinary Tract Stones With a Diameter≤2cm by Intelligent Pressure-controlled Flexible Ureteroscope
Urinary Calculi
About this trial
This is an interventional treatment trial for Urinary Calculi focused on measuring upper urinary stone, flexible ureteroscope, vacuum suction, stone free rate
Eligibility Criteria
Inclusion Criteria:
- The diameter of single stone or cumulative maximum diameter for multiple stones is less than or equal to 2cm
- American Society of Anesthesiology scores of 1to 2
- All patients participate in this study voluntarily and signed informed consent
Exclusion Criteria:
- Uncontrolled urinary tract infection
- Patients with pyonephrosis are found during operation
- The patients with abnormal anatomy (heterotopic kidney, horseshoe kidney, duplicate kidney), ureteral stricture, urethral stricture and urinary diversion
- Severe hydronephrosis
- Renal function was decompensated (serum creatinine > 178 μmol/L)
- Severe systemic hemorrhagic disease
- Patients who underwent bilateral surgery at the same time
- Severe deformity of hip joint and difficult position
Sites / Locations
- The Affiliated Ganzhou Hospital of Nanchang University (Ganzhou People's Hospital)Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Flexible ureteroscope with intelligent control of renal pelvic pressure(FURL-ICP)
Traditional flexible ureteroscope(f-URL)
Patients will be placed in supine lithotomy position with 60-90° oblique on the affected side upward. A pressure measuring ureteral access sheath (UAS) (11-14Fr) is inserted into the proximal ureter along the guidewire without fluoroscopic guidance. The pressure sensory and suctioning channels are connected to the irrigation and suctioning platform.
Each procedure is completed under general anesthesia in lithotomy position. A semi-rigid ureteroscopy is used to place a 0.032-inch guidewire. A pressure measuring ureteral access sheath (UAS) (11-14Fr) is inserted into the proximal ureter along the guidewire without fluoroscopic guidance. The irrigation and suctioning platform will be not used. A 7.5 Fr flexible ureteroscopy is used to break the stone with a holmium laser (fiber diameter 200 µm). A basket is used to remove the stone fragments. A 4-6Fr ureteral stent is left for 2 weeks after the operation. Stone composition is analyzed. If the UAS is failed to be placed, ureteral stent will be placed for 2 weeks and a second stage traditional f-URL will be performed.