778 860
SWL-treated patients. The methods of anaesthesia, sizes of
ureteroscopes, protocols for postoperative stenting, and
method of intracorporeal lithotripsy used in the reported
studies also varied.
Nine of the studies provided further breakdowns of SFRs
according to stone size
[20,22,26–29,31,33,35]. In all but
one of these studies
[20](which subdivided stones into
those 12 mm and
>
12 mm), this breakdown consisted of
stones
>
10 mm and stones
<
10 mm. With regards to
>
10 mm sized stones, five studies showed SFR to be
superior with URS
[20,26,29,31,33], whilst four studies
[22,27,28,35]showed no difference. For the smaller stones
Table 1 (
Continued
)
Study ID
Treatment Comparator
Outcome
No. of
patients
Value, % (
n
)
p
value
Treat Com Treat
Com
Fong 2004
[30]SWL
URS
SFR 1 mo
SFR 3 mo
50 51 50 (25)
78 (39)
80 (41)
90 (46)
<
0.05
NR
DP, mean min (range)
56 (20–105)
25 (5–120)
<
0.01
RTR
14 (7)
2 (1)
<
0.01
SP
14 (7)
8 (4)
0.3
CG 1
CG IIIb
2 (1)
4 (2)
0 (0)
0 (0)
NR
NR
Parker 2004
[31]SWL
URS
SFR SWL 1 overall
SFR SWL 1
<
10 mm
SFR SWL 1
>
10 mm
111 109 55
60 (44)
45 (17)
90.8
90 (73)
93 (26)
<
0.0001
<
0.0001
<
0.0001
DP, mean min SD (range)
<
10 mm
>
10 mm
50 17 (19–135)
59 28 (20–110)
78 36 (23–175)
101 53 (43–278)
NR
NR
SP
45
9
NR
AP
Stent
Nephrostomy
25.2 (28)
—
9.2 (10)
1.8 (2)
<
0.01
NR
Post-op visits, mean SD
2.4 1.2
1.4 0.8
<
0.0001
CG I
CG II
CG III
40.5 (45)
2.7 (3)
0 (0)
30.3 (33)
4.6 (5)
2.8 (3)
NR
>
0.05
NR
Pain (colic)
29 (32)
17 (19)
0.05
CA
Initial charge $1000 SD SWL
<
1 cm
Initial charge $1000 SD SWL
>
1 cm
Total charge $1000 SD SWL
<
1 cm
Total charge $1000 SD SWL
>
1 cm
9.4 2.2
9.7 2.6
14.9 7.6
16.9 7
7.6 3
7.3 3.5
9.2 4.4
10 7.1
<
0.0001
<
0.001
<
0.0001
<
0.0001
Wu 2004
[32]SWL
URS
SFR 1 mo
41 39 61 (25)
92.3 (36)
0.003
UI
0 (0)
0 (0)
NR
US
0
0
NR
AP
N/A
82 (32)
NR
SP
39 (16)
7.6 (3)
NR
HR
0 (0)
0 (0)
NR
EDV
3.3
1.6
NR
Lam 2002
[33]SWL
URS
SFR SWL 1
>
1 cm
SFR SWL 1
<
1 cm
SFR immediate
20
35
55
14
17
31
50 (10)
80 (28)
69.1 (38)
93 (13)
100 (17)
96.8 (30)
NR
NR
NR
RTR 1
>
1 cm
RTR 2
>
1 cm
RTR 3
>
1 cm
RTR 1
<
1 cm
RTR 2
<
1 cm
RTR 3
<
1 cm
50 (10)
15 (3)
5 (1)
20 (7)
0 (0)
0 (0)
7 (1)
0 (0)
0 (0)
0 (0)
0 (0)
0 (0)
NR
NR
NR
NR
NR
NR
DP, mean min (range)
stone
>
1 cm
Stone
<
1 cm
65.9 (55–100)
55.8 (50–76)
48.2 (29–86)
34.6 (24–44)
NR
NR
Hammad Ather
2001
[34]SWL
URS + lithoclast SFR
80 53 92 (73)
75(40)
NR
RTR
21 (17)
18 (9)
0.4570
AP = adjunctive procedure; CA = cost analysis; CG = Clavien Grade; CIRFR = clinically insignificant residual fragment; CIRFR-B = clinically insignificant residual
fragment at time point B (time point B being stated within parentheses in mo, but only up to 3 mo); Com = comparator; CR = complication rate; DHS = duration
of hospital stay; DP = duration of procedure; EDV = emergency department visit; HR = hospital readmission; HER = haematuria; n = number of; N/A = not
applicable; NR = not reported; NS = insignificant
p
value; MU = mid ureter; QOL = quality of life; Pain: use of painkillers (as specified by study authors);
RCT = randomised controlled trial; RO = radio-opaque; RTR = retreatment rate; SFR = stone free rate; SFR-B = SFR at time point B (time point B being stated
within parentheses in mo, but only up to 3 mo); SP = secondary procedure; STER = steinstrasse; SWL = shock-wave lithotripsy; TCC = time to complete
clearance; Treat = treatment; UI = ureteric injury; URS = ureteroscopy; UU = upper ureter; VAS = visual analogue scale; VS = voiding symptoms.
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 7 7 2 – 7 8 6
778