Forced Diuresis After Flexible Ureteroscopy for Medium-Sized Renal Stones

Ain Shams University

Status: Completed

Conditions: Kidney Stones

Treatments: Drug: Furosemide; Other: Standard Care After Flexible Ureteroscopy Without Furosemide

Study type: Interventional

Funder types: Other

Identifiers

NCT07336485

FMASU MS 685/2025

Details and patient eligibility

About

This randomized controlled clinical trial evaluated whether furosemide-assisted forced diuresis during flexible ureteroscopy reduced the residual fragment rate and improved the stone-free rate after flexible ureteroscopy for management of medium sized renal stones measuring up to 30 millimeters. Adult patients undergoing flexible ureteroscopy for renal stones were randomized into two parallel groups: an experimental group that received intravenous furosemide during the procedure and a control group that received standard perioperative and postoperative care without furosemide. Stone-free status and residual fragments were assessed using non-contrast computed tomography performed four weeks after the procedure, and residual fragments were classified by fragment size. Secondary outcomes included operative time, length of hospital stay, postoperative complications, total urine output in the first 24 hours, and the need for additional treatments for significant residual stones.

Enrollment: 2,000 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients aged 18 years or older.
• Patients who underwent flexible ureteroscopy for renal stones measuring 30 millimeters or less.

Exclusion criteria

• Patients with active urinary tract infection.
• Patients with a history of previous open renal surgery or renal trauma.
• Patients with contraindications to anesthesia, such as severe cardiac disease, uncontrolled diabetes mellitus, or severe coagulation disorder.
• Patients with severe renal impairment, defined as an estimated glomerular filtration rate less than 30 milliliters per minute per 1.73 square meters.
• Patients with a single kidney.
• Patients with contraindications to furosemide administration.
• Patients with congenital renal anomalies.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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2,000 participants in 2 patient groups

Furosemide-Assisted Forced Diuresis During Flexible Ureteroscopy

Experimental group

Description:

During flexible ureteroscopy, participants received intravenous furosemide 40 milligrams total, divided into 20 milligrams administered 5 minutes after induction of anesthesia and 20 milligrams administered 30 minutes after the start of the procedure.

Treatment:

Drug: Furosemide

Standard Care During Flexible Ureteroscopy Without Furosemide

Active Comparator group

Description:

Participants underwent flexible ureteroscopy and received standard perioperative and postoperative care without receiving intravenous furosemide or any other diuretic medication.

Treatment:

Other: Standard Care After Flexible Ureteroscopy Without Furosemide