SWL literature
SWL Literature

Yi X. et al., 2021: Comparison of the Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy and Flexible Ureteroscopy for Treatment of Urolithiasis in Horseshoe Kidney Patients: A Systematic Review and Meta-Analysis.

Yi X, Cao D, You P, Xiong X, Zheng X, Jin T, Peng G, Xu H, Liao D, Wei Q, Li H, Yang L, Ai J.
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Department of Urology, People's Hospital of Deyang City, Deyang, China.
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.

Abstract

Background: Urolithiasis is the most common complication of horseshoe kidney (HK), which can be treated by extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy (FURS), and percutaneous nephrolithotomy (PCNL). When comparing treatments of ESWL and FURS, it is unclear which is more efficient and safe. The objective of this study was to compare the efficacy and safety of FURS and SWL for the treatment of urolithiasis in HK patients. Methods: A systematic search of the Web of Science, PubMed, and EMBASE was performed in February 2021. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in each study. Results: Five studies published between 2008 and 2018 were synthesized in the present meta-analysis. The study revealed that FURS compared with SWL had greater initial and overall stone-free rates (SFRs). Risk ratios (RRs) were 2.46 (P < 0.00001) in initial SFRs, 1.36 (P = 0.02) in overall SFRs. No differences were found in the retreatment ratio, RRs were 0.49 (P = 0.43). In addition, no major complications were encountered, and all the complications were mild to moderate. Conclusion: The study demonstrated that FURS and SWL are effective and safe treatments for patients with HK with stones (<20 mm). Moreover, FURS has greater clearance rates and lower complication rates than SWL.
Front Surg. 2021 Oct 25;8:726233. doi: 10.3389/fsurg.2021.726233. eCollection 2021. PMID: 34760915. FREE ARTICLE

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Comments 1

Hans-Göran Tiselius on Thursday, May 12 2022 08:30

This article is a typical systematic review and meta-analysis of the effect of SWL and URS for removal of stones in patients with horseshoe kidneys. Also typical is it that the authors did not add any own treatment results.
The problem with stones in horseshoe kidneys is the abnormal anatomy with impaired outflow for urine and fragments. Only five studies qualified for being included in the study. The bottom-line is that although URS resulted in better stone-free rates, the results were acceptable also for SWL, at least when the stones were less than 20 mm.
The results of SWL were indeed slightly better than I personally expected, but it had been of interest to learn if some therapeutic tricks such as for instance inversion therapy would have resulted in further improved results for the two treatment modalities?
The important message of this report is as follows:

https://www.storzmedical.com/images/blog/Yi.JPG

Treatment results in terms of SFR were extracted from the article. There were no differences in re-treatment rates between the two methods!
Hans-Göran Tiselius

This article is a typical systematic review and meta-analysis of the effect of SWL and URS for removal of stones in patients with horseshoe kidneys. Also typical is it that the authors did not add any own treatment results. The problem with stones in horseshoe kidneys is the abnormal anatomy with impaired outflow for urine and fragments. Only five studies qualified for being included in the study. The bottom-line is that although URS resulted in better stone-free rates, the results were acceptable also for SWL, at least when the stones were less than 20 mm. The results of SWL were indeed slightly better than I personally expected, but it had been of interest to learn if some therapeutic tricks such as for instance inversion therapy would have resulted in further improved results for the two treatment modalities? The important message of this report is as follows: [img]https://www.storzmedical.com/images/blog/Yi.JPG[/img] Treatment results in terms of SFR were extracted from the article. There were no differences in re-treatment rates between the two methods! Hans-Göran Tiselius
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Friday, May 27 2022
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