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Phosphodiesterase 5 Inhibitors (PDE5i) (Sildenafil) as Medical Expulsive Therapy in Distal Ureteral Stones

Primary Purpose

Ureteral Stone, Urolithiasis

Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Sildenafil
Sponsored by
Mansoura University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ureteral Stone focused on measuring Phosphodiesterase 5 Inhibitors, PDE5i, Sildinafil

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male Patient aged from 18-65 years.
  2. Lower third ureteric stones at or below sacro-iliac joint .
  3. Stone size rang from 5- 10 mm.
  4. Unilateral ureteric stone

Exclusion Criteria:

  1. Patients who had recurrent fever.
  2. Patient underwent ESWL.
  3. Patient with rising serum creatinine > 2mg/dl.
  4. Patient with history of uretero-vesical reimplantation.
  5. Stone larger than 10 mm

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Placebo Comparator

    Active Comparator

    Arm Label

    control

    sildenafil

    Arm Description

    patient receive placebo for 4 weeks and followed for passage of stone distal ureter

    patient receive sildenafil 50 mg for 4 weeks once per day and followed for passage of stone distal ureter

    Outcomes

    Primary Outcome Measures

    the percentage of passage of lower ureteric stones.

    Secondary Outcome Measures

    number of patient need for analgesic treatment during their medical expulsive tharpy

    Full Information

    First Posted
    June 30, 2015
    Last Updated
    July 2, 2017
    Sponsor
    Mansoura University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02519153
    Brief Title
    Phosphodiesterase 5 Inhibitors (PDE5i) (Sildenafil) as Medical Expulsive Therapy in Distal Ureteral Stones
    Official Title
    Role of Phosphodiesterase 5 Inhibitors (PDE5i) (Sildenafil) in Management of Distal Ureteral Stone
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2017
    Overall Recruitment Status
    Unknown status
    Study Start Date
    July 2014 (undefined)
    Primary Completion Date
    August 2017 (Anticipated)
    Study Completion Date
    September 2017 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Mansoura University

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Urolithiasis is one of the most common urological diseases. The risk of urolithiasis is estimated to be between 5% and 12% all over the world with increased incidence in male rather than female (2:1) respectively . Ureteral stones account for 20% from all urinary tract stones, more than 70% of the ureteral stones found in the lower third of the ureter . The incidence of urinary stones has been increasing day by day. Medical expulsive therapy (MET) of ureteral stones is the investigators' concern in this study. Stone location, size, number, ureteral spasm, mucosal edema or inflammation and ureteral anatomy are the factors affecting passage of the ureteral stones. So, MET is based on mechanism that stone passage is facilitated by the relaxation of ureteral smooth muscle , increasing hydrostatic pressure proximal to the stone and decreasing exciting edema . There are many oral medication could be used as MET such as adrenergic blockers, calcium channel blockers, prostaglandin synthesis inhibitors, glyceryl trinitrate and steroid treatment . Calcium-channel blockers and adrenergic α-antagonists are the main that has been proposed to enhance stone passage as expulsive medical therapy. Cyclic nucleotides are degraded by phosphodiesterases enzymes (PDEs). So using of PDE inhibtors may play role in relaxation of smooth muscle of the ureter. A study was done for evaluation of three PDE5 inhibtors, sildenafil , vardenafil and tadalafil, they found that PDE5 inhibitors can reverse the tension of isolated human ureteral smooth muscle via cGMP-mediated pathways.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Ureteral Stone, Urolithiasis
    Keywords
    Phosphodiesterase 5 Inhibitors, PDE5i, Sildinafil

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    Participant
    Allocation
    Randomized
    Enrollment
    100 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    control
    Arm Type
    Placebo Comparator
    Arm Description
    patient receive placebo for 4 weeks and followed for passage of stone distal ureter
    Arm Title
    sildenafil
    Arm Type
    Active Comparator
    Arm Description
    patient receive sildenafil 50 mg for 4 weeks once per day and followed for passage of stone distal ureter
    Intervention Type
    Drug
    Intervention Name(s)
    Sildenafil
    Intervention Description
    placebo will take nitrofuratoin once daily for 4 weeks . sildenafil arm will take sildenafil 50 mg once daily for 4 weeks
    Primary Outcome Measure Information:
    Title
    the percentage of passage of lower ureteric stones.
    Time Frame
    one year
    Secondary Outcome Measure Information:
    Title
    number of patient need for analgesic treatment during their medical expulsive tharpy
    Time Frame
    one year

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Male Patient aged from 18-65 years. Lower third ureteric stones at or below sacro-iliac joint . Stone size rang from 5- 10 mm. Unilateral ureteric stone Exclusion Criteria: Patients who had recurrent fever. Patient underwent ESWL. Patient with rising serum creatinine > 2mg/dl. Patient with history of uretero-vesical reimplantation. Stone larger than 10 mm

    12. IPD Sharing Statement

    Learn more about this trial

    Phosphodiesterase 5 Inhibitors (PDE5i) (Sildenafil) as Medical Expulsive Therapy in Distal Ureteral Stones

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