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Evidence summaries

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. Level of evidence: "B"

A Cochrane review [Abstract] 1 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).

Primary/Secondary Keywords