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Skolarikos A et al, 2015: Manuscript Title: the Efficacy of Medical Expulsive Therapy (MET) in Improving Stone-Free Rate and Stone Expulsion Time, after Extracorporeal Shock Wave Lithotripsy (SWL) for Upper Urinary Stones: a Systematic Review and Meta-Analysis.

Skolarikos A, Grivas N, Kallidonis P, Mourmouris P, Rountos T, Fiamegos A, Stavrou S, Venetis C; Members of RISTA Study Group.
Second Department of Urology, Athens Medical School, Sismanogleio General Hospital, Athens, Greece.
Department of Urology, G. Hatzikosta General Hospital, Ioannina, Greece.
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Ippokrateio General Hospital, Thessaloniki, Greece.
Department of Urology, University of Ioannina, Ioannina, Greece.
First Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

In the current meta-analysis we analyzed the data of randomized studies on MET implemented following SWL for renal and ureteral stones. Pooled results demonstrated the efficacy of α-blockers, nifedipine, Rowatinex and Uriston in increasing stone clearance. In addition the time to stone elimination, the intensity of pain, the formation of steinstrasse and the need for auxillary procedures were reduced mainly with α-blockers. Expulsion rate was not correlated with the type of α-blocker, the stone diameter and the stone location. Although more studies are needed, our results show that MET for residual fragments after SWL should be implemented in clinical practice. 

Urology. 2015 Sep 14. pii: S0090-4295(15)00874-2. doi: 10.1016/j.urology.2015.09.004. [Epub ahead of print] Review

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Comments 1

Peter Alken on Wednesday, 02 December 2015 08:50

In the LIMITATIONS-section of their manuscript the authors seem to recommend a careful interpretation of this meta-analysis:

“The vast majority of randomized studies incorporated into the present systematic review were predominantly small, single-institution, not blinded studies, with an inadequately or unclear allocation concealment leading to a trend towards overestimating the effectiveness of treatment effects.”

In the LIMITATIONS-section of their manuscript the authors seem to recommend a careful interpretation of this meta-analysis: “The vast majority of randomized studies incorporated into the present systematic review were predominantly small, single-institution, not blinded studies, with an inadequately or unclear allocation concealment leading to a trend towards overestimating the effectiveness of treatment effects.”
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