Efficacy of emergency extracorporeal shock wave lithotripsy in the treatment of ureteral stones: a meta-analysis

Abstract

Objective To compare the clinical efficiency and safety of emergency extracorporeal shock wave lithotripsy (eESWL) and delayed extracorporeal shock wave lithotripsy (dESWL) in the treatment of ureteral stones. Methods Cochrane Library, PubMed, Google Scholar, and Web of Science were searched from inception to September 30, 2022, and all comparative studies involving eESWL and dESWL for ureteral calculi were included. Statistical analysis was performed using Review Manager 5.3 software. Results A total of 9 articles involving 976 patients diagnosed with ureteral stones were included. The results showed that the stone-free rate (SFR) after four weeks was significantly higher in the eESWL group than in the dESWL group [odds ratio (OR) = 2.19, 95% confidence interval (CI): 1.62–2.96, P < 0.01]. In subgroup analysis of different stone locations, proximal ureteral calculi [OR = 2.37, 95% CI: 1.66–3.38, P < 0.01] and mid-to-distal ureteral calculi [OR = 2.47, 95% CI: 1.23–4.97, P < 0.05] all showed a higher SFR in the eESWL group. eESWL significantly shortened the stone-free time(SFT) [mean difference (MD) = -5.75, 95% CI: -9.33 to -2.17, P < 0.01]. In addition, eESWL significantly reduced auxiliary procedures [OR = 0.45, 95% CI: 0.32–0.64, P < 0.01]. No significant difference in complications was found between the two groups [OR = 0.84, 95% CI: 0.56–1.27, P > 0.05]. Conclusion eESWL can significantly improve SFR, shorten SFT, and reduce auxiliary procedures.

The efficacy of early extracorporeal shockwave lithotripsy for the treatment of 5 to 10 mm upper ureteral stones: An observational study

“…In a meta-analysis that included 9 studies, SFR in upper ureteral stones was found to be 79.5% in early SWL and 63.4% in deferred SWL within 1 month follow-up. [6] In this study, the SFR within 1 month in the early SWL and deferred SWL groups were 85.5% and 71,8%, respectively. In both groups, the SFR was higher than that in the meta-analysis.…”

“…Some studies have reported that it is more successful if performed within the first 48 hours after the onset of colic pain. [5,6] The aim of this study aimed to determine the effectiveness of SWL performed in the early period, that is, within the first 24 hours, and to compare it with deferred SWL in terms of stone-free rates (SFR).…”