Calculous AnuriaNCT07627880
Initial Drainage Method and Flexible Ureteroscopy Outcomes in Calculous Anuria
A study testing Initial JJ Ureteral Stent Drainage and Initial Percutaneous Nephrostomy Drainage in people with Calculous Anuria and Upper Ureteral Stone, run by Beni-Suef University at 3 sites in Egypt.
Trial summary
Calculous anuria caused by obstructing upper ureteral stones in a solitary functioning kidney is a urological emergency requiring urgent decompression. Both retrograde JJ ureteral stenting and percutaneous nephrostomy are commonly used emergency drainage methods. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Calculous Anuria, Upper Ureteral Stone, Obstructive Uropathy
- What is being tested?
- Initial JJ Ureteral Stent Drainage and Initial Percutaneous Nephrostomy Drainage
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 3 sitesEgypt
- Study dates
- 6 May 2026to Apr 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 years or older.
- Calculous anuria secondary to a single upper ureteral stone.
- Solitary functioning kidney, whether anatomical or functional.
- Single upper ureteral stone confirmed by non-contrast computed tomography.
- Stone size from 6 mm to 20 mm in maximum diameter.
- Patient considered suitable for either initial JJ ureteral stent drainage or percutaneous nephrostomy drainage.
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- Candidate for definitive treatment by flexible ureteroscopy/retrograde intrarenal surgery.
- Documented renal functional improvement and clinical stabilization before definitive RIRS.
- Negative or appropriately treated urine culture before definitive RIRS.
- Ability and willingness to provide written informed consent.
Who cannot join
- Multiple stones or bilateral stones not fitting the solitary-kidney study design.
- Renal pelvic, distal ureteral, or multiple ipsilateral stones.
- Stone burden greater than 20 mm.
- Septic shock, hemodynamic instability, or need for emergency dialysis at presentation.
- Pyonephrosis requiring a non-randomized drainage decision.
- Anatomical abnormalities affecting endoscopic access, such as horseshoe kidney, pelvic kidney, ureterocele, or ureteral stricture.
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- Previous ipsilateral ureteral reconstructive surgery.
- Uncorrected coagulopathy.
- Pregnancy.
- Genitourinary malignancy.
- Inability to complete follow-up.
Trial locations and contacts
3 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt3 sites, 3 recruiting
- Recruiting
Department of Urology- Beni-Suef University Hospitals
Banī Suwayf, Beni Suweif Governorate
Hany F Badawy, MD, +201149525028, Hanyfathy86@gmail.com
Hany F Badawy, MD
- Recruiting
Department of Urology- Minia University Hospitals
Minya, Minya Governorate
M Abdelmalek, MD, +20 11 00464753
M Abdelmalek, MD
- Recruiting
Department of Urology- Tanta University Hospitals
Tanta
I, MD, +201060245430, MMohamed.elmaadawy@med.tanta.edu.eg
I Elmaadawy, MD
About this study
Official title: Impact of Initial Drainage Method on Flexible Ureteroscopy Outcomes in Patients Presenting With Calculous Anuria: A Multicenter Prospective Randomized Controlled Trial
Calculous anuria caused by obstructing upper ureteral stones in a solitary functioning kidney is a urological emergency requiring urgent decompression. Both retrograde JJ ureteral stenting and percutaneous nephrostomy are commonly used emergency drainage methods. However, limited evidence is available regarding whether the initial drainage method affects subsequent definitive flexible ureteroscopy/retrograde intrarenal surgery outcomes.
This multicenter prospective randomized controlled trial will compare emergency JJ ureteral stent drainage versus percutaneous nephrostomy drainage in adult patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, all participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery. The study will assess renal functional recovery, first-session surgical success, stone-free rate, operative parameters, complications, and microbiological outcomes.
Read the detailed description
This is a multicenter prospective randomized controlled trial comparing two emergency drainage strategies before definitive flexible ureteroscopy/retrograde intrarenal surgery in patients presenting with calculous anuria.
Adult patients with calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney will be assessed for eligibility. Eligible participants will be randomized in a 1:1 ratio to emergency retrograde JJ ureteral stent drainage or emergency percutaneous nephrostomy drainage. Randomization will be performed using a computer-generated random sequence, with allocation concealment using sequentially numbered opaque sealed envelopes.
Participants assigned to the JJ stent group will undergo emergency retrograde placement of a 6 Fr JJ ureteral stent under cystoscopic guidance. Participants assigned to the percutaneous nephrostomy group will undergo emergency ultrasound-guided placement of an 8 Fr nephrostomy tube. After drainage, participants will be monitored for urine output recovery, renal functional improvement, symptom relief, and clinical stabilization.
Definitive flexible ureteroscopy/retrograde intrarenal surgery will be scheduled after renal functional improvement, clinical stabilization, and negative or appropriately treated urine culture. The definitive procedure will be performed using a standardized operative strategy. Ureteral access sheath use, successful insertion, need for adjunctive ureteral maneuvers, operative time, laser time, fluoroscopy time, postoperative stenting, complications, and hospital stay will be recorded.
The primary outcome is renal functional recovery after initial drainage and definitive surgery, assessed using serial serum creatinine measurements at presentation, 24 to 48 hours after drainage, before definitive surgery, postoperative day 1, and follow-up. Secondary outcomes include first-session definitive surgery success, stone-free rate, technical operative variables, intraoperative and postoperative complications, microbiological culture patterns, and predictors of surgical success or postoperative complications.
Participants will be followed for approximately one month after definitive surgery by clinical assessment, laboratory evaluation, and imaging for assessment of renal function, complications, and stone clearance.
- Being tested
- Initial JJ Ureteral Stent Drainage, Initial Percutaneous Nephrostomy Drainage
- Keywords
- Percutaneous nephrostomy, Double-J ureteral stent, Retrograde intrarenal surgery
- Medical subject headings
- Ureterolithiasis, Acute Kidney Injury
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Initial JJ Ureteral Stent DrainageProcedure or surgery
Retrograde cystoscopic placement of a 6 Fr JJ ureteral stent for initial upper urinary tract decompression in patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery.
Initial Percutaneous Nephrostomy DrainageProcedure or surgery
Ultrasound-guided placement of an 8 Fr percutaneous nephrostomy tube for initial upper urinary tract decompression in patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery.
| Study group | Role | What they receive |
|---|---|---|
| JJ Ureteral Stent Drainage Group | Active comparator | Participants randomized to this arm will undergo emergency retrograde placement of a 6 Fr double-J ureteral stent under cystoscopic guidance for decompression of calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, definitive flexible ureteroscopy/retrograde intrarenal surgery will be performed according to the standardized study protocol. Receives: Procedure: Initial JJ Ureteral Stent Drainage |
| Percutaneous Nephrostomy Drainage Group | Active comparator | Participants randomized to this arm will undergo emergency ultrasound-guided placement of an 8 Fr percutaneous nephrostomy tube for decompression of calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, definitive flexible ureteroscopy/retrograde intrarenal surgery will be performed according to the standardized study protocol. Receives: Procedure: Initial Percutaneous Nephrostomy Drainage |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Serum Creatinine From After Initial Drainage to After Definitive RIRS
Serum creatinine will be measured in mg/dL at 24-48 hours after initial drainage and on postoperative day 1 after definitive tratment of stone by retrograde intrarenal surgery. The primary outcome will compare the change in serum creatinine from the post-drainage value to the post-RIRS value between the JJ ureteral stent drainage group.
Measured: From 24-48 hours after initial drainage to postoperative day 1 after definitive RIRS
Secondary outcomes (6)
First-Session Definitive RIRS Success Rate
First-session definitive RIRS success will be defined as successful completion of flexible ureteroscopy/retrograde intrarenal surgery for the target upper ureteral stone in the planned first definitive session without the need to abort the procedure or schedule an additional unplanned definitive stone procedure during the same treatment pathway. The proportion of participants achieving first-session success will be compared between the JJ ureteral stent drainage group and the percutaneous nephrostomy drainage group.
Measured: During the definitive RIRS procedure
Stone-Free Rate After Definitive RIRS
Stone-free rate will be defined as the proportion of participants with no detectable residual target stone fragment on follow-up non-contrast computed tomography performed 4 weeks after definitive flexible ureteroscopy/retrograde intrarenal surgery. Stone-free rate will be compared between the JJ ureteral stent drainage group and the percutaneous nephrostomy drainage group
Measured: 4 weeks after definitive RIRS
During the definitive RIRS procedure
Total operative time will be measured in minutes from insertion of the cystoscope or ureteroscope to completion of the definitive flexible ureteroscopy/retrograde intrarenal surgery procedure. Mean or median operative time will be compared between the JJ ureteral stent drainage group and the percutaneous nephrostomy drainage group.
Measured: During the definitive RIRS procedure
Need for Ureteral Stenting After Definitive RIRS
The need for postoperative ureteral stent placement after definitive flexible ureteroscopy/retrograde intrarenal surgery will be recorded. The proportion of participants requiring postoperative stenting will be compared between both drainage groups
Measured: At the end of the definitive RIRS procedure
Intraoperative Complications During Definitive RIRS
Intraoperative complications will include ureteral mucosal injury, false passage, ureteral perforation, bleeding affecting visualization, and procedure interruption. The incidence of intraoperative complications will be compared between both drainage groups.
Measured: During the definitive RIRS procedure
Postoperative Infectious Complications After Definitive RIRS
Postoperative infectious complications will include fever greater than 38°C, systemic inflammatory response syndrome, or sepsis after definitive flexible ureteroscopy/retrograde intrarenal surgery. The incidence of postoperative infectious complications will be compared between both drainage groups.
Measured: From definitive RIRS to 4 weeks after definitive RIRS
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2026
- Study start6 May 2026
- Primary completionMar 2027 (estimated)
- Study completionApr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Calculous AnuriaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized in a 1:1 ratio to one of two emergency drainage strategies: retrograde JJ ureteral stent drainage or percutaneous nephrostomy drainage. After renal functional improvement, clinical stabilization, and appropriate urine culture management, all participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Beni-Suef University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hany Fathy Badawy, MD, Beni-Suef University
- Investigators
- Hany F Badawy, MD, Principal investigator, Faculty of medicine BeniSuef University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07627880
- Sponsor's protocol ID
- FMB050526-ANURIA-RIRS
- Status last verified
- May 2026
- First submitted
- 30 May 2026
- Last updated
- 4 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared because the study includes individual-level clinical, laboratory, radiological, operative, and microbiological data from patients presenting with an emergency urological condition. Only aggregated and de-identified study results will be reported. Any future sharing of individual participant data would require additional approval from the Research Ethics Committee and an appropriate data-sharing agreement.
Study at a glance
From the registry record, last updated by the sponsor on 4 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Initial Drainage Method on Flexible Ureteroscopy Outcomes in Patients Presenting With Calculous Anuria: A Multicenter Prospective Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07627880
- Acronym / sponsor ID
- FMB050526-ANURIA-RIRS
- Keywords
- Percutaneous nephrostomy, Double-J ureteral stent, Retrograde intrarenal surgery
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Beni-Suef UniversityUniversity, hospital or other
- Study start
- 6 May 2026 (actual)
- Primary completion
- Mar 2027 (estimated)
- Study completion
- Apr 2027 (estimated)
- First posted
- 4 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Calculous anuria caused by obstructing upper ureteral stones in a solitary functioning kidney is a urological emergency requiring urgent decompression. Both retrograde JJ ureteral stenting and percutaneous nephrostomy are commonly used emergency drainage methods. However, limited evidence is available regarding whether the initial drainage method affects subsequent definitive flexible ureteroscopy/retrograde intrarenal surgery outcomes.
This multicenter prospective randomized controlled trial will compare emergency JJ ureteral stent drainage versus percutaneous nephrostomy drainage in adult patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, all participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery. The study will assess renal functional recovery, first-session surgical success, stone-free rate, operative parameters, complications, and microbiological outcomes.
Detailed description
This is a multicenter prospective randomized controlled trial comparing two emergency drainage strategies before definitive flexible ureteroscopy/retrograde intrarenal surgery in patients presenting with calculous anuria.
Adult patients with calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney will be assessed for eligibility. Eligible participants will be randomized in a 1:1 ratio to emergency retrograde JJ ureteral stent drainage or emergency percutaneous nephrostomy drainage. Randomization will be performed using a computer-generated random sequence, with allocation concealment using sequentially numbered opaque sealed envelopes.
Participants assigned to the JJ stent group will undergo emergency retrograde placement of a 6 Fr JJ ureteral stent under cystoscopic guidance. Participants assigned to the percutaneous nephrostomy group will undergo emergency ultrasound-guided placement of an 8 Fr nephrostomy tube. After drainage, participants will be monitored for urine output recovery, renal functional improvement, symptom relief, and clinical stabilization.
Definitive flexible ureteroscopy/retrograde intrarenal surgery will be scheduled after renal functional improvement, clinical stabilization, and negative or appropriately treated urine culture. The definitive procedure will be performed using a standardized operative strategy. Ureteral access sheath use, successful insertion, need for adjunctive ureteral maneuvers, operative time, laser time, fluoroscopy time, postoperative stenting, complications, and hospital stay will be recorded.
The primary outcome is renal functional recovery after initial drainage and definitive surgery, assessed using serial serum creatinine measurements at presentation, 24 to 48 hours after drainage, before definitive surgery, postoperative day 1, and follow-up. Secondary outcomes include first-session definitive surgery success, stone-free rate, technical operative variables, intraoperative and postoperative complications, microbiological culture patterns, and predictors of surgical success or postoperative complications.
Participants will be followed for approximately one month after definitive surgery by clinical assessment, laboratory evaluation, and imaging for assessment of renal function, complications, and stone clearance.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomized in a 1:1 ratio to one of two emergency drainage strategies: retrograde JJ ureteral stent drainage or percutaneous nephrostomy drainage. After renal functional improvement, clinical stabilization, and appropriate urine culture management, all participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery.
| Arm | Type | Receives |
|---|---|---|
| JJ Ureteral Stent Drainage Group | Active comparator | Procedure: Initial JJ Ureteral Stent DrainageParticipants randomized to this arm will undergo emergency retrograde placement of a 6 Fr double-J ureteral stent under cystoscopic guidance for decompression of calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, definitive flexible ureteroscopy/retrograde intrarenal surgery will be performed according to the standardized study protocol. |
| Percutaneous Nephrostomy Drainage Group | Active comparator | Procedure: Initial Percutaneous Nephrostomy DrainageParticipants randomized to this arm will undergo emergency ultrasound-guided placement of an 8 Fr percutaneous nephrostomy tube for decompression of calculous anuria caused by a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, definitive flexible ureteroscopy/retrograde intrarenal surgery will be performed according to the standardized study protocol. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Adults aged 18 years or older.
- Calculous anuria secondary to a single upper ureteral stone.
- Solitary functioning kidney, whether anatomical or functional.
- Single upper ureteral stone confirmed by non-contrast computed tomography.
- Stone size from 6 mm to 20 mm in maximum diameter.
Key exclusion criteria (11 listed)
- Multiple stones or bilateral stones not fitting the solitary-kidney study design.
- Renal pelvic, distal ureteral, or multiple ipsilateral stones.
- Stone burden greater than 20 mm.
- Septic shock, hemodynamic instability, or need for emergency dialysis at presentation.
- Pyonephrosis requiring a non-randomized drainage decision.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Initial JJ Ureteral Stent DrainageRetrograde cystoscopic placement of a 6 Fr JJ ureteral stent for initial upper urinary tract decompression in patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery. | Procedure or surgery | JJ Ureteral Stent Drainage Group |
| Initial Percutaneous Nephrostomy DrainageUltrasound-guided placement of an 8 Fr percutaneous nephrostomy tube for initial upper urinary tract decompression in patients presenting with calculous anuria due to a single upper ureteral stone in a solitary functioning kidney. After renal functional improvement, clinical stabilization, and appropriate urine culture management, participants will undergo standardized definitive flexible ureteroscopy/retrograde intrarenal surgery. | Procedure or surgery | Percutaneous Nephrostomy Drainage Group |
Primary outcome
Change in Serum Creatinine From After Initial Drainage to After Definitive RIRS
Time frame: From 24-48 hours after initial drainage to postoperative day 1 after definitive RIRS
Serum creatinine will be measured in mg/dL at 24-48 hours after initial drainage and on postoperative day 1 after definitive tratment of stone by retrograde intrarenal surgery. The primary outcome will compare the change in serum creatinine from the post-drainage value to the post-RIRS value between the JJ ureteral stent drainage group.
6 secondary outcomes
First-Session Definitive RIRS Success Rate
Time frame: During the definitive RIRS procedure
Stone-Free Rate After Definitive RIRS
Time frame: 4 weeks after definitive RIRS
During the definitive RIRS procedure
Time frame: During the definitive RIRS procedure
Need for Ureteral Stenting After Definitive RIRS
Time frame: At the end of the definitive RIRS procedure
Intraoperative Complications During Definitive RIRS
Time frame: During the definitive RIRS procedure
Postoperative Infectious Complications After Definitive RIRS
Time frame: From definitive RIRS to 4 weeks after definitive RIRS
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Jun 2026.
- Individual participant dataSharing planned: No. Individual participant data will not be shared because the study includes individual-level clinical, laboratory, radiological, operative, and microbiological data from patients presenting with an emergency urological condition. Only aggregated and de-identified study results will be reported. Any future sharing of individual participant data would require additional approval from the Research Ethics Committee and an appropriate data-sharing agreement.
Related trials for Calculous Anuria
RecruitingPhase 2
Intravesical Aminophylline for Urgent Ureteral Stenting in Acute Calculous Anuria
Acute Calculous Anuria, Ureteral Calculi
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Hany F Badawy, MD principal investigator
Faculty of medicine BeniSuef University
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Initial JJ Ureteral Stent Drainage and Initial Percutaneous Nephrostomy Drainage in people with Calculous Anuria and Upper Ureteral Stone, run by Beni-Suef University at 3 sites in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 4 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hany F Badawy, MD (+201149525028, HANYFATHY86@GMAIL.COM), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Serum Creatinine From After Initial Drainage to After Definitive RIRS (time frame: From 24-48 hours after initial drainage to postoperative day 1 after definitive RIRS). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jun 2026.