Efficacy Management of Urolithiasis: Flexible Ureteroscopy versus Extracorporeal Shockwave Lithotripsy

Täuber,; Wohlmuth, M.; Hochmuth, A; Schimetta, Wolfgang; Fs, Krause

doi:10.1159/000439356

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…A total of 2,265 patients were finally enrolled in our meta-analysis, of which 1,227 (54.17%) patients were enrolled in the f-URS group and the other 1,038 (45.83%) patients were enrolled in the SWL group. There were eight RCTs ( 18 , 22 , 23 , 26 – 29 , 31 ) and nine cohort studies ( 4 , 8 , 17 , 19 – 21 , 24 , 25 , 30 ) included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis

Qi²,

Gao³

et al. 2022

Front. Surg.

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ObjectiveThis study aims to compare the safety and efficacy of extracorporeal shock wave lithotripsy (SWL) and flexible ureteroscopy lithotripsy (f-URS) in treating urinary tract stones.MethodsWe systematically searched PubMed, Embase, and Cochrane for literature comparing SWL with f-URS. The primary outcomes we focused on were stone-free rate (SFR) and complications; the secondary outcomes were operation time, hospital stay, retreatment rate, number of sessions, and auxiliary procedures rate. We used ReviewManager version 5.4.1 and STATA version 14.2 for meta-analysis.ResultsSeventeen studies with a total of 2,265 patients were included in the meta-analysis, including 1,038 patients in the SWL group and 1,227 patients in the f-URS group. The meta-analysis indicated that patients in the f-URS group had higher SFR than those in the SWL group [odds ratio (OR): 2.00, 95% confidence interval (CI): 1.29–3.12, p = 0.002]. In addition, we found no significant difference in complications (OR: 1.08, 95% CI: 0.85–1.37) between the two treatments. Also, we found that the retreatment rate and the auxiliary procedure rate in the f-URS group were significantly lower than those in the SWL group (OR: 0.08, 95% CI: 0.02–0.24, p < 0.00001; OR: 0.30, 95% CI: 0.11–0.83, p = 0.02). Moreover, the number of sessions in the f-URS group was significantly lower than that in the SWL group [mean difference (MD): −1.96, 95% CI: −1.55 to −0.33, p = 0.003]. However, the operation time and hospital stay in the f-URS group were significantly longer than those in the SWL group (MD: 11.24, 95% CI: 3.51–18.56, p = 0.004; MD: 1.14, 95% CI: 0.85–1.42, p < 0.00001).ConclusionFor 1–2-cm urinary stones, f-URS can achieve a higher SFR than SWL while having a lower retreatment rate, number of sessions, and auxiliary procedure rate. For urinary stones <1 cm, there was no significant difference in SFR between SWL and f-URS groups. The SWL group has a shorter operative time and hospital stay than the f-URS group.

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Section: Resultsmentioning

confidence: 99%

Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis

Qi²,

Gao³

et al. 2022

Front. Surg.

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“…The management of LPS is one of the most interesting topics in urology, and discussions continue about the best treatment option. There are a limited number of comparative studies on the treatment of LPS with SWL and f-URS [ 6 - 8 ]. In this prospective study, we found a significantly higher stone-free rate following f-URS compared to SWL with similar complication rates.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study

Kezer¹

2022

Cureus

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Introduction:The objective of the study is to clarify the efficiency, safety, and limitations of shock wave lithotripsy (SWL) and flexible ureterorenoscopy (f-URS) in the management of lower pole stones (LPS).Methods: The present study was planned prospectively in a non-randomized manner. Patients who had LPS between 10 and 20 cm in size were enrolled in the study. Patient demographic characteristics, stone-related parameters, complications, and success were noted. Patients who underwent SWL and patients who underwent f-URS were compared according to demographic characteristics, procedure-related parameters, complications, and success rate.Results: A total of 82 patients matched the study inclusion criteria, with 44 patients treated with SWL and 38 patients treated with f-URS. The time between diagnosis and the end of the treatment was 29.2 days in the SWL group and 15.2 days in the f-URS group (p = 0.001). The success rate was 89.5% with f-URS and 72.7% with SWL (p = 0.036). Receiver operating curve analysis revealed that a stone size larger than 14 mm in the lower pole was significantly associated with SWL failure (area under the curve [AUC]: 0.711, p = 0.033), and a stone size larger than 16 mm was a predictive factor for f-URS failure. Conclusion:The present study found that f-URS had a significantly higher stone-free rate in the management of 10-20 mm LPS compared to SWL. For the first time, this study showed that the time between diagnosis and the end of treatment was significantly shorter with f-URS. Moreover, LPS larger than 14 mm and 16 mm were predictive factors for SWL and f-URS failure, respectively.

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“…Along with the development of new ureteroscopes and progress of the manufacturing technology of ureteroscope-related accessory equipment, ureteroscopes are increasingly used in the diagnosis and treatment of upper urinary tract diseases, especially kidney stones (11). Holmium laser optic, basket extractor, nipper, and ureteroscope delivery sheath are tools for stone crush and removal.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of FURL and PCNL with holmium laser for the treatment of kidney stones

Zhao

Fan

et al. 2016

Experimental and Therapeutic Medicine

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In the present study, the clinical effects of flexible ureteroscopy lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) for the treatment of kidney stones of ≤2 cm was studied. Seventy-two patients with kidney stones were randomly divided into the FURL group (n=39) under ureteroscope lithotripsy with holmium laser and PCNL group (n=33) under PCNL with holmium laser and compared their clinical effects. At 3 months after the operation, the stone removal rate of the FURL group was significantly higher than that of the PCNL group. The subgroup analysis revealed that the difference in the lower kidney calyx was more obvious (P<0.05) while the difference in the complex kidney stones was not statistically significant (P>0.05). The incidence of complications of the FURL group was significantly lower than that of the PCNL group (P<0.05). The operation time and recurrence rate of the FURL group were significantly less than that of the PCNL group (P<0.05). Differences regarding the creatinine and urea nitrogen levels before operation, and 3 and 7 days after the operation between the two groups were not statistically significant (P>0.05). Additionally, 3 and 7 days after operation, the cystatin C levels of the FURL group were significantly higher than those of the PCNL group, and the KIM-1 levels were significantly lower than the PCNL group (P<0.05). In conclusion, compared with PCNL with holmium laser, FURL with holmium laser was more safe and effective in treating kidney stones ≤2 cm. Therefore, the method is worthy of wide application in clinic.

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Efficacy Management of Urolithiasis: Flexible Ureteroscopy versus Extracorporeal Shockwave Lithotripsy

Cited by 9 publications

References 24 publications

Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis

Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis

Comparison of Shock Wave Lithotripsy and Flexible Ureterorenoscopy in the Treatment of 10–20 mm Lower Pole Stone: Prospective Non-randomized Study

Clinical effects of FURL and PCNL with holmium laser for the treatment of kidney stones

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