Management of symptomatic ureteral stones
Upfront vs Postponed Ureteroscopy (UPURS) Trial for Patient-centered Management of Symptomatic Obstructing Stones
This study tests whether treating ureteral stones right away with a procedure is better than waiting to see if they pass on their own for people who come to the emergency room with this problem.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of California, San Francisco Academic / other |
| Locations | 1 site (San Francisco, California) |
| Trial ID | NCT05715086 on ClinicalTrials.gov |
What this trial studies
This trial investigates the management of symptomatic ureteral stones by comparing two approaches: upfront ureteroscopy versus observation and delayed intervention. Patients presenting to the emergency department with a ureteral stone will be randomized into one of the two groups. The study aims to address the variability in treatment decisions influenced by factors such as practice setting and insurance status, which can lead to health disparities. By establishing clearer, patient-centered guidelines, the trial seeks to improve care for vulnerable populations.
Who should consider this trial
Good fit: Ideal candidates are adults over 18 years old presenting to the emergency department with a symptomatic ureteral stone of at least 5mm diagnosed via CT scan.
Not a fit: Patients with strict indications for stenting or those whose stone burden is not amenable to ureteroscopy may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could lead to more effective and equitable management of symptomatic ureteral stones.
How similar studies have performed: Other studies have explored similar management strategies for ureteral stones, but this trial aims to provide more definitive patient-centered guidelines.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Presenting to the Emergency Department (ED) * Adult (\> 18 yo) * ≥5mm ureteral stone diagnosed on CT scan * Presence of symptoms (pain, nausea, vomiting, hematuria) Exclusion Criteria: * Strict indication for stent * Stone burden not amenable to Ureteroscopy (URS) * Dirty urine analysis (UA) or positive urine culture (UCx) * Transplant kidney * Presence of conduit * Comorbidities not optimized for surgery * Strong preference for surgery or observation
Where this trial is running
San Francisco, California
- University of California, San Francisco — San Francisco, California, United States (Recruiting)
Study contacts
- Principal investigator: Thomas Chi, MD — University of California, San Francisco
- Study coordinator: Catherine Arevalo, BA
- Email: catherine.arevalo@ucsf.edu
- Phone: 415-514-0918
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.