Extra-corporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi

Ureteroscopic removal of ureteral stones appears to achieve a higher stone-free state but with a higher complication rate and a longer hospital stay.

A Cochrane review included 7 studies with a total of 1 205 subjects. Stone-free rates were lower in the ESWL group (RR 0.84 95% CI 0.73 to 0.96; 7 studies, n=1 205) and ESWL-treated patients had higher re-treatment rates compared with ureteroscopically-treated patients (RR 6.18, 95% CI 3.68 to 10.38; 6 studies, n=1 049). ESWL-treated patients had less need for auxiliary treatment (RR 0.43, 95% CI 0.25 to 0.74; 5 studies, n=751); fewer complications (RR 0.54, 95% CI 0.33 to 0.88; 7 studies, n=1 205); and shorter length of hospital stay (MD -2.55 days, 95% CI -3.24 to -1.86; 2 studies, n=198).

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding).

Ədəbiyyat

1. Aboumarzouk OM, Kata SG, Keeley FX et al. Extracorporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi. Cochrane Database Syst Rev 2012;(5):CD006029.