Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) versus Pneumatic Ureteroscopic Lithotripsy (URSL) for Lower Ureteral Stones Therapy in Asia: A Meta-Analysis ()
ABSTRACT
Objective: To assess
the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic
ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to
identify and summarize randomized controlled trials that were used to treat
distal ureteral stone. Methods:
Eligible studies were identified from electronic databases. Database search,
quality assessment, and data extraction were performed by two reviewers
independently. Our primary outcome was the stone-free
rate. Secondary outcomes were the fragmentation rate, complications and the
rate of re-treatment and secondary procedures. The results were assessed by
Review Manager 5.0. Publication bias was evaluated by Stata 11.0. Results: 13 trials were included. Meta-analysis of pooled data showed that
pneumatic ureteroscopic lithotripsy demonstrated a significant advantage over extracorporeal shock
wave lithotripsy (OR = 0.14, 95% CI
[0.09, 0.23], P < 0.00001) in the stone-free rate; the extracorporeal shock wave
lithotripsy had statistical disadvantages
over pneumatic ureteroscopic lithotripsy in the fragmentation rate of ureteral stones (OR = 0.14, 95% CI [0.05, 0.39], P = 0.0002);
and the rate of re-treatment and secondary procedure was lower in
pneumatic ureteroscopic lithotripsy
than in extracorporeal shock wave lithotripsy (OR = 5.37, 95% CI [2.61, 11.07], P < 0.00001). Our
pooled results showed that there was no statistical difference between
extracorporeal shock wave lithotripsy and pneumatic ureteroscopic lithotripsy
in hematuresis, ureteral stricture and urosepsis or fever. Finally
extracorporeal shock wave lithotripsy had a higher incidence of colic pain than
pneumatic ureteroscopic lithotripsy. Conclusion:
The present meta-analysis suggested that pneumatic ureteroscopic
lithotripsy had large advantages over extracorporeal
shock wave lithotripsy in the treatment
of lower ureteral stones.
Share and Cite:
T. Li, S. Fu, X. Ming, L. Yang, J. Cheng and Z. Wang, "Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) versus Pneumatic Ureteroscopic Lithotripsy (URSL) for Lower Ureteral Stones Therapy in Asia: A Meta-Analysis,"
International Journal of Clinical Medicine, Vol. 5 No. 1, 2014, pp. 4-11. doi:
10.4236/ijcm.2014.51002.