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Intra-nasal Ketorolac for Acute Ureteral Stent-associated Pain Following Ureteroscopy for Stone Disease

RecruitingPhase 1/2

Intra-nasal Ketorolac Versus Oral Diclofenac for Acute Ureteral Stent-associated Pain Following Ureteroscopy for Stone Disease

Who can join

Ages 18 and older · All sexes

Full eligibility criteria
Inclusion Criteria:

* ≥18 years old
* English-speaking
* Candidate for unilateral ureteroscopy for treatment of urolithiasis
* Surgical plan includes placement of a ureteral stent

Exclusion Criteria:

* Pregnant/nursing, prisoners, cognitively impaired
* Solitary kidney
* Stone in transplant kidney
* Anatomic abnormalities (i.e., ureteral stricture, infundibular stenosis, uretero-pelvic junction obstruction, horseshoe kidney, duplicated system)
* History of ureteral reconstruction
* History of nephrocalcinosis, medullary sponge kidney, cystinuria
* Immobility or relative immobility
* Planned staged ureteroscopy
* History of ureteral stent complication or poor tolerance or a ureteral stent
* Urinary tract infection or sepsis
* Current anticoagulation use (81 mg Aspirin permissible)
* NSAID contraindication (acute renal failure or chronic kidney disease, bleeding disorders, allergic reaction to NSAIDs, ulcer disease, auto-immune disease)

About the study

Objective: To improve quality-of-life and health care delivery to patients receiving ureteral stents.

Specific Aims: Evaluate the feasibility, practicality, and qualitative outcomes of utilizing intra-nasal ketorolac in patients with indwelling ureteral stents (Phase I), followed by a randomized trial comparing two non-steroidal anti-inflammatory drugs, intra-nasal Ketorolac versus oral Diclofenac.

Hypotheses: Due to its favorable pharmacokinetics in relieving acute pain, investigators expect improved pain scores and a lower rate of unplanned clinical encounters in patients receiving intra-nasal ketorolac compared to those taking oral diclofenac following ureteroscopic surgery for urolithiasis.

Study Rationale: Following ureteroscopic management of urolithiasis, patient with indwelling ureter stents have higher levels of discomfort compared to those without a ureter stent. Prior studies showed that intramuscular Ketorolac at time of ureter stent removal decreased the incidence of unplanned clinical encounters. Furthermore, onset of analgesic effect by intra-nasal ketorolac is faster than its oral form, and similar its intramuscular and intravenous counterparts.

What is being tested

Sponsor: University of Texas Southwestern Medical Center · Participants: 80 · Started: Mar 1, 2025

Contact the study team

Official record on ClinicalTrials.gov — NCT06158620

Locations in the U.S.

TexasUT Southwestern Medical Center, Dallas

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.