Stone Cone Device vs. Standard URS for Proximal Ureteral Calculi

A Randomized Controlled Trial Comparing Stone Clearance and Retrograde Migration in Ureteroscopic Pneumatic Lithotripsy for Proximal Ureteral Calculi Performed With and Without the Stone Cone Anti-Retropulsion Device

Retrograde migration of stone fragments into the kidney during ureteroscopic lithotripsy (URS) for proximal ureteral stones is a common technical challenge, occurring in 5-40% of cases. This can lead to residual fragments and lower stone-free rates. The Stone Cone is an anti-retropulsion device designed to trap fragments and prevent their migration. This study will test the hypothesis that the use of the Stone Cone during URS pneumatic lithotripsy will result in a significantly higher stone clearance rate at 48 hours post-procedure compared to the standard technique without the device.

Inclusion Criteria:

• A solitary proximal ureteral stone ≤ 2 cm in size as confirmed by imaging.
• Normal renal function.

Exclusion Criteria:

• Active urinary tract infection (clinical features or pyuria).
• Bleeding disorder (abnormal prothrombin time or activated partial thromboplastin time).
• Chronic kidney disease (raised urea and creatinine).
• Stone > 2 cm in size.