Vanderbilt University Medical Center
Ryan Hsi
Flexible ureteroscopy is characterized as first-line therapy for renal stones < 2 cm in size. Stones are commonly treated with dusting or fragmentation techniques which requires passage of stone fragments after surgery. Quoted stone free rate after flexible ureteroscopy is approximately 40-60% with a dusting technique. Residual fragments are often under 1mm in size and can layer in the lower pole of the kidney, complicating spontaneous stone passage. Improving the stone free rate after surgery decreases the need for secondary surgeries and decreases risk of future stone events. Numerous techniques have been proposed to increase stone passage including positional changes and percussion therapy. To date, there is overall limited data a lack of techniques that can be readily available in the outpatient setting, easily added to scheduled appointments, reproducible results and well tolerated by patients.
Nephrolithiasis
Massage Percussion Therapy device
Not Applicable
Researchers in China have developed a proprietary oscillation machine to be used in an outpatient setting. The External Physical Vibration Lithecbole (EPVL) is used to provide vibration after stone fragmentation to facilitate movement of fragments into a more favorable orientation for stone passage. After extracorporeal shockwave lithotripsy and ureteroscopy, use of EPVL after surgery has been shown to increase stone free rate. Chest percussion for cystic fibrosis patients has been adapted for use after ureteroscopy. After undergoing extracorporeal shockwave lithotripsy, patients are placed in a percussion physiotherapy vest, given diuretics and positioned in Trendelenburg. Imaging obtained before and after percussion demonstrates successful stone movement and increases stone free rates in several different protocols compared to patients who do not receive percussive therapy. Percussion therapy is clearly effective to improve stone free rates after ureteroscopy and is effective regardless of technique, protocol, or percussive device. However, proposed techniques with EPVL and chest physiotherapy vests can be expensive, cumbersome and require specialty equipment. In addition, proposed equipment in prior studies is not readily available in outpatient clinics.}}
| Study Type : | Interventional |
| Estimated Enrollment : | 80 participants |
| Masking : | None (Open Label) |
| Primary Purpose : | Treatment |
| Official Title : | Massage Percussion Therapy for Passage of Urolithiasis Fragments After Ureteroscopy |
| Actual Study Start Date : | February 1, 2024 |
| Estimated Primary Completion Date : | December 2024 |
| Estimated Study Completion Date : | December 2025 |
| Arm | Intervention/treatment |
|---|---|
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No Intervention: Control Patient receives standard postoperative care with no percussion therapy. |
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Experimental: PACU percussion Patient receives percussion therapy in the PACU immediately after surgery. |
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Experimental: Postoperative appointment percussion Patient receives percussion therapy in the office on the day of follow up. |
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Experimental: Both PACU and Postop appointment percussion. Patient receives percussion therapy in the PACU and receives percussion therapy in the office on the day of follow up. |
| Ages Eligible for Study: | 18 Years |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Accepts Healthy Volunteers |
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Recruiting
University of Montreal
Montréal, Canada,