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Patient Positioning for Treatment of Proximal Ureteral Stones

Optimal Patient Positioning and Strategy for the Treatment of Proximal Ureteral Stones

Who can join

Ages 18 and older · All sexes

Inclusion criteria:

* Adults aged 18 years and older.
* Diagnosed with kidney stones and scheduled for fURS.
* Stone burden \> 1 cm and/or multiple stones will be eligible.
* Able and willing to provide informed consent.

Exclusion criteria:

* Pregnant persons as determined by pre-operative urine pregnancy test (standard of care at the institution)
* Untreated UTI
* Patients with urinary anomalies (e.g., urinary diversion, ureteral reconstruction, horseshoe kidney)
* Single stone \< 1 cm

About the study

Ureteroscopic management of proximal ureteral stones presents technical challenges including stone retropulsion, prolonged operative time, and conversion to intrarenal treatment. Reverse Trendelenburg positioning has been shown to reduce proximal stone migration and operative time in ureteral stones, while the T-tilt position improves intrarenal stone clearance. The optimal strategy for proximal ureteral stones (treating stones in situ using reverse Trendelenburg versus pushing stones into the kidney followed by intrarenal treatment in T-tilt) remains unknown.

This randomized controlled trial compares these two strategies, with primary focus on operative time as a measure of procedural efficiency.

A total of 54 patients (27 per arm) will be enrolled at Mount Sinai West.

What is being tested

• Reverse Trendelenburg Position (procedure)
• T-Tilt Position (procedure)

Sponsor: Icahn School of Medicine at Mount Sinai · Participants: 54 · Started: May 21, 2026

Contact the study team

• Mantu Gupta, MD · Phone: 212-241-1272
• Blair Gallante, MPH · Phone: 212-241-1272

Official record on ClinicalTrials.gov — NCT07601932

Locations in the U.S.

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