A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size
<i>Background and Objectives:</i> This systematic review and meta-analysis was conducted to analyze the treatment outcomes of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) according to the ureteral stone size. <i>Materials and Methods:</i> In this systemat...
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MDPI AG
2021-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/12/1369 |
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| author | Hae Do Jung Youna Hong Joo Yong Lee Seon Heui Lee |
| author_facet | Hae Do Jung Youna Hong Joo Yong Lee Seon Heui Lee |
| author_sort | Hae Do Jung |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> This systematic review and meta-analysis was conducted to analyze the treatment outcomes of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) according to the ureteral stone size. <i>Materials and Methods:</i> In this systematic review, relevant articles that compared SWL and URSL for treatment of ureteral stones were identified. Articles were selected from four English databases including Ovid-Medline, Ovid-EMBASE, the Cochrane Central Register of controlled Trials (Central), and Google Scholar. A quality assessment was carried out by our researchers independently using the Scottish Intercollegiate Guidelines Network (SIGN). A total of 1325 studies were identified, but after removing duplicates, there remained 733 studies. Of these studies, 439 were excluded, 294 were screened, and 18 met the study eligibility criteria. <i>Results</i>: In randomized control trial (RCT) studies, URSL showed significantly higher SFR than SWL (<i>p</i> < 0.01, OR= 0.40, 95% CI 0.30–0.55, I² = 29%). The same results were shown in sub-group analysis according to the size of the stone (<1 cm: <i>p</i> < 0.01, OR = 0.40, 95% CI 0.25–0.63; >1 cm: <i>p</i> < 0.01, OR = 0.38, 95% CI 0.19–0.74, I² = 55%; not specified: <i>p</i> < 0.01, OR = 0.43, 95% CI 0.25–0.72, I² = 70%). In the non-RCT studies, the effectiveness of the URSL was significantly superior to that of SWL (<i>p</i> < 0.01, OR = 0.33, 95% CI 0.21–0.52, I² = 83%). Retreatment rate was significantly lower in URSL than in SWL regardless of stone size (<i>p</i> < 0.01, OR = 10.22, 95% CI 6.76–15.43, I² = 54%). <i>Conclusions:</i> Meta-analysis results show that SFR was higher than SWL in URSL and that URSL was superior to SWL in retreatment rate. However, more randomized trials are required to identify definitive conclusions. |
| first_indexed | 2024-03-10T03:36:01Z |
| format | Article |
| id | doaj.art-48272fa61ff34b10b621ee5d46d76687 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T03:36:01Z |
| publishDate | 2021-12-01 |
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| spelling | doaj.art-48272fa61ff34b10b621ee5d46d766872023-11-23T09:29:03ZengMDPI AGMedicina1010-660X1648-91442021-12-015712136910.3390/medicina57121369A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone SizeHae Do Jung0Youna Hong1Joo Yong Lee2Seon Heui Lee3Department of Urology, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo 15865, KoreaDivision of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, Seoul 04554, KoreaDepartment of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Nursing Science, College of Nursing, Gachon University, Incheon 22212, Korea<i>Background and Objectives:</i> This systematic review and meta-analysis was conducted to analyze the treatment outcomes of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) according to the ureteral stone size. <i>Materials and Methods:</i> In this systematic review, relevant articles that compared SWL and URSL for treatment of ureteral stones were identified. Articles were selected from four English databases including Ovid-Medline, Ovid-EMBASE, the Cochrane Central Register of controlled Trials (Central), and Google Scholar. A quality assessment was carried out by our researchers independently using the Scottish Intercollegiate Guidelines Network (SIGN). A total of 1325 studies were identified, but after removing duplicates, there remained 733 studies. Of these studies, 439 were excluded, 294 were screened, and 18 met the study eligibility criteria. <i>Results</i>: In randomized control trial (RCT) studies, URSL showed significantly higher SFR than SWL (<i>p</i> < 0.01, OR= 0.40, 95% CI 0.30–0.55, I² = 29%). The same results were shown in sub-group analysis according to the size of the stone (<1 cm: <i>p</i> < 0.01, OR = 0.40, 95% CI 0.25–0.63; >1 cm: <i>p</i> < 0.01, OR = 0.38, 95% CI 0.19–0.74, I² = 55%; not specified: <i>p</i> < 0.01, OR = 0.43, 95% CI 0.25–0.72, I² = 70%). In the non-RCT studies, the effectiveness of the URSL was significantly superior to that of SWL (<i>p</i> < 0.01, OR = 0.33, 95% CI 0.21–0.52, I² = 83%). Retreatment rate was significantly lower in URSL than in SWL regardless of stone size (<i>p</i> < 0.01, OR = 10.22, 95% CI 6.76–15.43, I² = 54%). <i>Conclusions:</i> Meta-analysis results show that SFR was higher than SWL in URSL and that URSL was superior to SWL in retreatment rate. However, more randomized trials are required to identify definitive conclusions.https://www.mdpi.com/1648-9144/57/12/1369ureteral calculilithotripsyureteroscopysystematic reviewmeta-analysis |
| spellingShingle | Hae Do Jung Youna Hong Joo Yong Lee Seon Heui Lee A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size Medicina ureteral calculi lithotripsy ureteroscopy systematic review meta-analysis |
| title | A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size |
| title_full | A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size |
| title_fullStr | A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size |
| title_full_unstemmed | A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size |
| title_short | A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size |
| title_sort | systematic review on comparative analyses between ureteroscopic lithotripsy and shock wave lithotripsy for ureter stone according to stone size |
| topic | ureteral calculi lithotripsy ureteroscopy systematic review meta-analysis |
| url | https://www.mdpi.com/1648-9144/57/12/1369 |
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