JCU - January 2022 - 8

8
Journal of Clinical Urology 15(1)
Enrollment
Assessed for eligibility (n=109)
Excluded (n=9)
♦ Not meeting inclusion criteria (n=4 )
♦ Declined to participate (n=2)
♦ Other reasons (n=2)
Randomized (n=100)
Allocation
Allocated to intervention (n= 50)
♦ Received allocated intervention (n=50)
Allocated to intervention (n= 50)
♦ Received allocated intervention (n=50)
Follow-Up
Follow-Up (n= 50)
Follow-Up (n= 50)
Analysis
Analysed (n=50)
Analysed (n=50)
Figure 1. Consort diagram for our study.
Figure 3. Antegrade injection of the contrast media.
Amplatz sheath (Cook Urological, Spencer, IN) was used
for this procedure. Stones were fragmented using a ballistic
lithotripter (Swiss Lithoclast, EMS Corp., Dallas, TX),
and the particles were removed using a stone grasper. The
removal of all the stones and particles was confirmed both
endoscopically and fluoroscopically upon the completion
of the procedure. Finally, an 18 Fr Foley catheter was
placed as a nephrostomy tube.
Figure 2. Creation of 'bull's eye' sign for appropriate needle
advancement.
technique. Once the appropriate calyx was accessed, a
0.035-inch J-tip guide wire was passed through the ureter.
If unsuccessful, it was allowed to be coiled in the
opposite calyx or renal pelvis. A second (working) wire
was also placed alongside the wire.
Afterward, a metallic cone-tip 26 Fr dilator designed by
the author, as a one-shot dilator was used to dilate the tract
under fluoroscopic guidance. A 24 Fr rigid nephroscope
(Richard Wolf, Knittlingen, Germany) through a 28 Fr
In patients with impacted ureteropelvic junction stone and
those with postoperative small scattered stone particles, a 4.8
Fr JJ stent was inserted antegradely under fluoroscopic guidance.
For uncomplicated patients who had a single stone or
lower stone burden preoperatively or those with complete
stone clearance and minimal bleeding, however, no nephrostomy
tube was inserted (totally tubeless procedure). As an
alternative, in patients with failed antegrade access, the use
of a fluoroscopically antegrade approach by an interventional
radiologist under ultrasound scan or switching to the
conventional retrograde method was considered.
Parenteral antibiotic (ceftriaxone 1 g b.i.d.) was used
for 48 hours postoperatively. Pain relief was achieved
through the administration of pethidine hydrochloride (50
mg/mL), 0.5-2 mg/kg body weight intramuscularly every
three to four hours.
Statistical analysis
Data analysis was performed using SPSS v17 (SPSS, Inc.,
Chicago, IL). The comparison between quantitative variables
was performed using an independent t-test. The chisquare
test was used to compare qualitative variables
between the two groups. p-Values of <0.05 were considered
statistically significant.

JCU - January 2022

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JCU - January 2022 - Cover1
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JCU - January 2022 - Cover3
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