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RECRUITING Not applicable ClinicalTrials.gov

Effect of Emergency Urinary Drainage on Subsequent PCNL Outcomes in Obstructive Urosepsis

Sponsor: Beni-Suef University • ClinicalTrials.gov ID: NCT07826325

Registry updated: 2026-09-17
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Description

Obstructive urolithiasis complicated by urosepsis is a life-threatening medical emergency requiring urgent urinary tract decompression. Emergency drainage is typically achieved by either retrograde ureteral stent (RUS) insertion or percutaneous nephrostomy (PCN). Following clinical stabilization and resolution of infection, percutaneous nephrolithotomy (PCNL) is commonly performed as definitive stone treatment. This prospective comparative study aims to evaluate and compare the outcomes of subsequent PCNL between patients who underwent emergency drainage via retrograde ureteral stent and those who underwent percutaneous nephrostomy. The main outcomes to be compared include stone-free rates, operative time, blood loss, postoperative complications, length of hospital stay, and the need for auxiliary procedures.

Interventions

  • Retrograde Ureteral Stenting followed by PCNL (Procedure)
    Emergency decompression via retrograde ureteral stent (Double-J stent) placement under fluoroscopic guidance, along with intravenous antibiotic therapy and resuscitation. Once sepsis resolves, inflammatory markers normalize, and urine culture becomes sterile, definitive percutaneous nephrolithotomy (PCNL) is performed.
  • Percutaneous Nephrostomy followed by PCNL (Procedure)
    Emergency decompression via ultrasound- and/or fluoroscopy-guided percutaneous nephrostomy (PCN) tube insertion, combined with intravenous antibiotics and resuscitation. After complete resolution of sepsis, normalization of inflammatory parameters, and confirmation of sterile urine, definitive percutaneous nephrolithotomy (PCNL) is performed.

Eligibility criteria

Inclusion Criteria: * Age 18 years or older. * Presence of renal or proximal ureteral stones. * Presentation with urosepsis secondary to obstructive urolithiasis. * Emergency urinary decompression performed by either retrograde ureteral stent (Double-J stent) or percutaneous nephrostomy (PCN). * Patients scheduled for definitive stone management via percutaneous nephrolithotomy (PCNL) after clinical stabilization and infection resolution. * Written informed consent obtained prior to enrollment. Exclusion Criteria: * Congenital renal anomalies (e.g., horseshoe kidney, ectopic kidney). * Pregnancy. * Uncorrectable coagulopathy or bleeding disorders. * Active, uncontrolled urinary tract infection at the time of definitive PCNL. * Severe cardiopulmonary comorbidities rendering the patient unfit for surgery or general anesthesia. * Patients managed definitively by other modalities (e.g., ureteroscopy or ESWL alone).

Conditions

Urosepsis Kidney Stone

Locations

  • Faculty of Medicine, Beni-Suef University — Banī Suwayf, Beni Suweif Governorate, Egypt
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

View Official Record