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Patient Education Videos

What is SOUL? An Introduction.

Ureteroscopy and Stent Walk-Through by Renown Surgeon Dr. Casey Dauw of the University of Michigan/Michigan Medicine

What happens if I get a stent? What happens if I don’t get a stent? Three patient experiences.

FAQ

  • Who can participate?

    • Age ≥18 years

    • Undergoing unilateral ureteroscopy and lithotripsy and stent placement for stone disease (participants may have contralateral stones, as long as these are asymptomatic and not being treated concurrently)

    • Largest stone ≤ 10mm in size as measured on abdominal x-ray, ultrasound, or CT scan. Overall stone burden can be greater than 10mm but the largest stone size allowed is 10mm or less.

    • Adequate independent cognitive function and English language pro ciency to complete study surveys

  • Who cannot participate?

    • Planned bilateral ureteroscopy

    • Indwelling ureteral stent or percutaneous nephrostomy tube preoperatively in either kidney

    • Anatomic abnormalities of the ipsilateral upper urinary tract (e.g. horseshoe kidney, crossed fused ectopia, pelvic kidney, urinary diversion)

    • Anatomic or functional solitary kidney

    • Planned secondary or staged ureteroscopy • Planned use of ureteral access sheath

    • Pregnancy

    • Patients who use opiate medication daily for >3 months to manage a painful condition

  • Can I use a stent on a string?

    Absolutely. Your choice of stent is completely up to you as well as the duration.

  • What are the two groups available to patients?

    Randomized: Patient’s stent placement is based on a digital coin flip. 50% chance of getting a stent and 50% chance of omission. Provider has oversight t override digital coin fli results for patient safety. Patient must pass Second Stage Eligibility to be randomized.

    Observational: Assuming patient passes Second Stage Eligibility, provider has complete digression regarding stent placement.

  • What is Second Stage Eligibility?

    Patient MUST be free of the following to participate in SOUL. If patient fails Second Stage Eligibiity, please contact the MUSIC Coordinating Center within 24 hours to report..

    • Ureteral Perforation

    • Unanticipated anatomic abnormality (e.g. ureteral stricture or ureteropelvic junction obstruction)

    • Greater than expected bleeding • Ureteral dilation performed (>12 French)

    • Failed ureteroscopy (unable to treat stone, requiring stent or nephrostomy)

    • No lithotripsy performed (e.g. no stone found)

    • Intraoperative decision to perform incomplete lithotripsy • Unable to complete case due to medical or anesthetic event

    • Other (provide description/will need to discuss with coordinating center PI within 7 days)

  • Can patients move cohorts?

    Pre-operatively, yes. Patient will need to sign a new consent indicating which cohort they would like to be in.

    Peri or Post-Operatively, no. Patent is unable to change cohorts once surgery has begun.