Evaluating Gentamicin Irrigation and Suction-Enabled Ureteral Access Sheath to Reduce Infection Risks Following Retrograde Intrarenal Surgery for Kidney Stones

What this Trial Is About

Researchers are evaluating ways to reduce infections after retrograde intrarenal surgery RIRS, a common minimally invasive treatment for kidney stones up to 20 mm. This trial examines the effects of gentamicin-containing irrigation fluid and a suction-enabled ureteral access sheath on postoperative complications such as fever, systemic inflammatory response syndrome SIRS, and sepsis. The study uses a 2x2 factorial design to assess the independent and combined benefits of these two interventions, which target bacterial contamination and elevated intrarenal pressure, respectively. Participants will undergo RIRS under general anesthesia. The study compares four groups standard saline irrigation with a standard ureteral sheath gentamicin added to irrigation fluid with a standard sheath suction-enabled ureteral sheath with standard irrigation and both gentamicin irrigation and suction sheath together. Gentamicin is locally added to irrigation fluid at a dose of 80 mg per 3 L saline bag, while suction-assisted sheaths aim to improve fluid drainage and reduce pressure during the procedure. Stone fragmentation is performed with a holmiumYAG laser, and a ureteral stent is placed afterward. During the study, participants are monitored for infectious outcomes within 48 hours after surgery, including fever, SIRS, and sepsis. Additional assessments include stone-free rates at 4 weeks and changes in blood and urine tests. The trial collects data on urine and blood cultures, white blood cell counts, and kidney function markers. These measures help determine the effects of the interventions on postoperative infection risks and surgical success over the course of follow-up.

Antibiotic Irrigation and Suction Ureteral Access Sheath in RIRS