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Comparison of Lithotomy Versus Lateral Position in Retrograde Intrarenal Surgery for Lower Calyceal Stones Less Than 2 cm

ConditionRenal Calculi
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorMenoufia University

About this trial

Retrograde intrarenal surgery (RIRS) is an established minimally invasive treatment for renal stones, particularly for lower calyceal stones less than 2 cm, offering acceptable stone-free rates with low morbidity.

However, stone clearance in the lower calyx remains technically challenging due to unfavorable anatomy, limited scope deflection, and gravity-dependent fragment retention. Patient positioning during RIRS has been suggested as a modifiable factor that may influence endoscopic access, stone relocation, and surgical ergonomics.

The lithotomy position is conventionally used during RIRS, while the lateral position has been proposed to facilitate stone migration and improve lower calyceal access through gravitational assistance. Existing studies comparing patient positioning during RIRS are limited, with most evidence derived from retrospective analyses or non-randomized designs.

Therefore, this randomized controlled trial aims to compare lithotomy versus lateral positioning during RIRS for lower calyceal stones less than 2 cm in terms of operative and clinical outcomes.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adults aged ≥18 years.

Single or multiple lower calyceal renal stones with stone size <2 cm confirmed by NCCT.

Negative urine culture.

Presented cases.

Disqualifiers

Multiple stones involving renal pelvis or other calyces.

Anatomical anomalies affecting ureteroscope access (horseshoe kidney, malrotation, ureteral strictures).

Pregnancy.

Prior ipsilateral renal surgery.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Lithotomy Position

    Procedure/Surgery

    Patients undergo RIRS in lithotomy position

  • Lateral position

    Procedure/Surgery

    Patients undergo RIRS in lateral position

Treatment groups

70 Participants
are divided into 2 treatment groups
Group A: Lithotomy position groupActive comparator 1 intervention
Group B: Lateral position groupActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Stone Free Rate

Stone-free rate (SFR), defined as no clinically significant residual stones on non-contrast 3-mm-cuts CT, measured as yes or no

Time frame
1 month

Secondary outcomes

1

Operative time

operative time is defined as time between starting the procedure and termination of it measured in minutes

Time frame
The operative time
2

Complications

Intra and postoperative complications, defined as complications happens intraoperative and postoperatively, graded by modified clavien-dindo classification

Time frame
1 month

Other outcomes

Locations

1

Map coordinates are unavailable for these locations. Locations are shown below instead.

Menoufia Faculty of Medicine Status unavailable 32511, Shebin El-Kom, MenoufiaEgyptEgypt

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Menoufia University

Lead sponsor

Source ClinicalTrials.gov

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