Abstract:
:The objective of this study is to explore the efficacy and safety of mechanical percussion combined with changed patient position (MPPP) on elimination of residual stones/fragments in the upper urinary tract. The study was a systematic review and meta-analysis. A systematic literature review using Pubmed, Embase, Medline, and Cochrane Library was conducted to obtain randomized-controlled trials (RCTs) evaluating the efficacy and safety of MPPP treatment of patients with residual stones/fragments in the upper urinary tract. The retrieval of data ended in October 2018. Statistical analysis was carried out using summarized unadjusted risk ratios (RRs) with 95% confidence intervals (CIs). Seven RCTs comprising 1132 patients were included. Compared with patients in the control group, patients treated with MPPP had higher stone-free rates (SFRs) with RR 1.55 (CI 1.11-2.18; p = 0.01) and lower complication rates with RR 0.48 (CI 0.25-0.94, p = 0.03). In subgroup analysis based on stone location, the SFR for the lower calyx was significantly higher in the intervention group than in the control group: RR 1.80 (CI 1.47-2.21, p < 0.00001). In subgroup analysis based on complication type, compared with the control patients, the intervention patients had lower hematuria rate with RR 0.46 (CI 0.28-0.74, p = 0.001) and lower leucocyturia rate with RR 0.33 (CI 0.12-0.89, p = 0.03). MPPP is a worthwhile non-invasive method for elimination of residual stones/fragments in the upper urinary tract. Furthermore, we recommend MPPP for patients with residual stones or fragments located in the lower calyces.
journal_name
Urolithiasisjournal_title
Urolithiasisauthors
Zeng T,Tiselius HG,Huang J,Deng T,Zeng G,Wu Wdoi
10.1007/s00240-019-01140-2subject
Has Abstractpub_date
2020-04-01 00:00:00pages
95-102issue
2eissn
2194-7228issn
2194-7236pii
10.1007/s00240-019-01140-2journal_volume
48pub_type
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