An interventional study of Percutaneous nephrostomy and Retrograde ureteric JJ stent in Ureteric Calculus, Sepsis and Hydronephrosis, sponsored by The Adelaide and Meath Hospital, incorporating The National Children's Hospital. Withdrawn at 2 sites in Ireland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-09-27.
Sponsored by The Adelaide and Meath Hospital, incorporating The National Children's Hospital · Not applicable, Interventional, and Treatment
Randomized control trial to compare the efficacy and safety of percutaneous nephrostomy with retrograde ureteric stenting for emergency renal decompression in cases of obstruction and sepsis associated with ureteric calculi.
The obstructed kidney in the setting of urosepsis is a urological emergency. Stone manipulation in the setting of active, untreated infection with concomitant urinary tract obstruction can lead to life-threatening sepsis. Therefore, urgent decompression of the collecting system is warranted.
There are two options for urgent decompression of an obstructed collecting system:
This strategy allows drainage of infected urine and penetration of antibiotics to the affected renal unit. Definitive stone manipulation should be delayed until the infection is cleared following an appropriate course of antimicrobial therapy.
Both the European Association of Urology (EAU) and the American Urological Association (AUA) provide guidelines for management of an obstructed kidney. Both organisations provide evidence-based statements of the highest recommendation that urgent decompression of the kidney is mandated in the setting of sepsis. However, neither organisation recommend one decompression modality over the other. There is a lack of high quality up-to-date evidence to support a consensus view that one method of decompression is superior to the other.
This study aims to determine the most effective method of renal decompression in cases of obstruction and sepsis associated with ureteric calculi.
84 studies on the registry are indexed under Ureterolithiasis; 19 are open to participants now.
Browse Ureterolithiasis studies →The Adelaide and Meath Hospital, incorporating The National Children's Hospital is the lead sponsor of 6 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Percutaneous nephrostomy
Procedure: Percutaneous nephrostomy
Retrograde ureteric JJ stent
Procedure: Retrograde ureteric JJ stent
Percutaneous nephrostomy tube insertion under radiological guidance
Retrograde ureteric JJ stent insertion using cystoscopy
Time to normalisation of white cell count and/or temperature
Time frame: Within 1 week
Length of hospital stay
Time frame: Within 1 week
Plan to share: No
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This study is withdrawn, as verified in Sep 2022. You cannot join it, but the record below documents what was studied.
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The Adelaide and Meath Hospital, incorporating The National Children's Hospital