The treatment involves taking oral medications for four weeks after the stone-breaking procedure. During this time, patients will receive either a combination of tamsulosin and furosemide, or standard pain relief medications including ibuprofen and paracetamol. The study will monitor how well the stones are cleared from the urinary system and assess the level of pain experienced by patients.

The research will use special imaging techniques to check if the stone fragments have been successfully cleared from the kidney and urinary tract. The success of the treatment will be determined by the absence of stones or the presence of only very small fragments (less than 3 millimeters in size) after four weeks of treatment. The study will also track how much pain medication patients need during and after the procedure.

The research aims to determine if using these medications together can improve the success rate of kidney stone removal and reduce the need for additional treatments. The study will also examine how this combination of medicines affects pain levels that patients experience. During the study, some patients may receive ibuprofen or paracetamol for pain relief as needed.

The treatment period lasts for several weeks after the shock wave lithotripsy procedure. Patients will be monitored to check how well they are passing the stone fragments and to assess their comfort levels. The success of the treatment will be determined by checking if all stone fragments have been cleared from the urinary system.

Participants in the study will undergo the flexible ureteroscopy procedure, after which they will receive either Furosemide or a placebo. The study will monitor the stone-free rate at three months using a low-dose CT scan, a type of imaging that helps visualize the inside of the body. Additionally, the study will assess any post-operative urinary tract infections, post-operative pain, and any adverse events related to Furosemide. The effect of prescribing an alpha-blocker, a type of medication that can help relax certain muscles, will also be evaluated in relation to the primary outcome of the study.

The trial aims to provide valuable insights into whether Furosemide can effectively aid in the removal of kidney stone fragments after laser treatment. The results will be reviewed by specialized radiologists to ensure consistency and accuracy. This study is expected to conclude by December 2025, with recruitment having started in September 2023.

Participants in the study will receive one of the following treatments: spinal morphine, which is derived from the opium poppy and administered directly into the spinal fluid, or intravenous lidocaine, a common local anesthetic given through a vein. Additionally, some patients will receive a combination of bupivacaine, another local anesthetic, and adrenaline, which helps prolong the effects of the anesthetic. The purpose of the study is to determine if these treatments can enhance recovery after surgery, as measured by a patient-centered outcome scale called “Quality of Recovery 15.”

The study will involve a random assignment of treatments to participants, and it will be conducted without the participants knowing which treatment they are receiving. The trial will monitor recovery progress, including pain levels and overall well-being, at various points after surgery. The goal is to find the most effective pain management strategy to improve the recovery experience for patients undergoing this type of surgery.