Efficacy and safety of various surgical treatments for proximal ureteral stone ≥10mm: A systematic review and network meta-analysis

Wang, Yaxuan; Chang, Xueliang; Li, Jingdong; Han, Zhenwei

doi:10.1590/s1677-5538.ibju.2019.0550

Cited by 16 publications

(11 citation statements)

References 40 publications

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“…On looking to the outcomes of our study, results of RCTs 5‐7,21‐24 (Table 3) and data of systematic reviews and meta‐analyses, 3,4,25,26 it appears that LPU for treatment of large proximal ureteric stone has the highest SFR reaching up to 100% in most studies 6,7,23,24 . SWL and URS required more auxiliary procedures to reach a stone‐free status.…”

Section: Discussionmentioning

confidence: 84%

“…Recently, several systematic reviews and meta‐analyses have studied LPU outcomes in comparison to URS for treatment of large proximal ureteric stones 3,4,25,26 . Meta‐analysis of six RCTs including 646 patients (325 URS and 321 LPU) were analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, LPU was associated with better initial and final SFR, fewer major complications (grade ≥3), fewer ureteral strictures, and lower auxiliary procedures compared with URS and laser lithotripsy 25 . In another recent systematic review and meta‐analysis of 25 studies and 2888 patients, Wang et al concluded that LPU had the potential to be considered as the first treatment choice of proximal ureteral stones ≥10 mm, owing to its higher initial and final SFR: LU > PCNL> URS > SWL 26 …”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review

Raheem

Alowidah

Hagras

et al. 2020

Asian J Endoscop Surgery

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Introduction We evaluated the efficacy and safety of laparoscopic ureterolithotomy (LPU) for the treatment of large proximal ureteric stone. Methods A retrospective multicenter analysis for patients with solitary impacted proximal ureteric stone ≥15 mm who underwent LPU from 2016 to 2019 was performed. Primary outcome was to estimate the stone‐free rate (SFR). SFR was defined as absence of residual stones on postoperative computed tomography scan. Secondary outcome was to assess the perioperative outcomes, as well as to review literature data of randomized controlled trials and meta‐analyses comparing LPU to other treatment options. Results Forty‐four patients were included in our study. Mean stone size was 22.9 ± 5.8 mm and median follow‐up was 14 months. Three patients had previous abdominal surgery, one patient had severe degree of scoliosis and six patients failed primary therapy. All stones were extracted successfully (SFR = 100%) without need of auxiliary treatments. Mean operative time and estimated blood loss were 86.6 ± 14.1 minutes. and 11.9 ± 14.7 mL, respectively. No intraoperative complications or conversion to open surgery were reported. No major postoperative complications (≥grade 3) were reported. Mean length of hospital stay was 2 ± 0.8 days. Conclusions For treatment of large ureteric stones, our study showed that LPU achieves 100% stone‐free status. When performed by well‐trained laparoscopic surgeons, it is safe and has no major perioperative complications. According to our results and literature data, when counseling patients with large impacted proximal ureteral stones, LPU should be advised as the procedure that has the higher SFR, lower auxiliary treatments, and comparable complication rates to other treatments.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review

Raheem

Alowidah

Hagras

et al. 2020

Asian J Endoscop Surgery

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“…TUL, ESWL, laparoscopic surgery, PCNL are other options to treatment ureteral stones. A meta--analysis demonstrated that LU and PCNL are good procedures for patients with large proximal ureteral stones (15).…”

Section: Discussionmentioning

confidence: 99%

The effects of pregabalin, solifenacin and their combination therapy on ureteral double-J stent-related symptoms: A randomized controlled clinical trial

et al. 2021

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Background: Many medical therapies have been tested to deal with urinary stentrelated symptoms (USRS). Several preventive and pharmaceutical methods have been already used for better compatibility of stents. However, the existing evidence for pharmacological treatment is still controversial. This study aims to evaluate the effects of pregabalin, solifenacin, and combination therapy on ureteral double-J stent-related symptoms following ureteroscopy and transureteral lithotripsy (TUL). Materials and methods: In a randomized controlled clinical trial, from November 2017 to March 2019, 256 patients who underwent ureteroscopy were enrolled. Patients were randomly divided into four groups including: group A received pregabalin 75mg BID (twice daily), group B received solifenacin 5mg orally once daily, group C received combination of pregabalin and solifenacin and the group D (control) given no drugs. Results: One hundred and fifty-one (58.9%) males and 101 (41.1%) females were enrolled in this study with a mean age of 43.47±7 (p=0.32, p=0.67). USSQ domains score such as urinary symptoms, pain, general condition, work performance, sexual matters and additional problems were significantly differenced during second and fourth week of follow-up among study groups (p <0.0001). In Tukey's multiple comparison test, urinary symptoms (p=0.735), pain (p=0.954) and sexual matters (p=0.080) in second week and work performance in forth week in group B was not significantly better than group D. Only group C in all indexes of USSQ showed significantly beneficial effects over group D (p <0.0001). Conclusion: Combination therapy of pregabalin and solifenacin has a significant effect on stent-related symptoms and is preferred over monotherapy of the respected medications.

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“…Extracorporeal shockwave lithotripsy (ESWL) is a method recommended by guidelines for the noninvasive treatment of kidney stones and upper ureter stones 1 . The procedure had been increasingly performed since its initial use 40 years ago 2,3 . ESWL is the first‐line treatment, especially in treating <2 cm kidney stones and <1 cm ureter stones 4 .…”

Section: Introductionmentioning

confidence: 99%

The effect of music on state anxiety in patients undergoing extracorporeal shockwave lithotripsy

Doğan¹,

Ceylan

2021

Int J Clin Pract

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Extracorporeal shockwave lithotripsy (ESWL) is a method recommended by guidelines for the noninvasive treatment of kidney stones and upper ureter stones. 1 The procedure had been increasingly performed since its initial use 40 years ago. 2,3 ESWL is the first-line treatment, especially in treating <2 cm kidney stones and <1 cm ureter stones. 4 It is a pretty successful treatment method and is available now in many urology clinics. One of the factors affecting its success is the compliance of the patients. Decreasing pain levels and anxiety sensations is important for patients to provide a good observation. Guidelines strongly recommend appropriate pain relief during the procedure in reference to related studies. 5,6 The main purpose of pain prevention is to avoid undesired movements and disrupted focus because of excessive respiratory activity. Inability to complete the procedure because of pain intolerance also decreases the procedure's success rate. 7 The use of music as a therapeutic method has existed since ancient times. Studies have shown that music can reduce stress and anxiety during medical procedures by distracting attention. 8 While music alone is not a means of treatment, it is often used as a supportive method. 9 Music has been indicated to suppress

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Efficacy and safety of various surgical treatments for proximal ureteral stone ≥10mm: A systematic review and network meta-analysis

Cited by 16 publications

References 40 publications

Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review

Laparoscopic ureterolithotomy for large proximal ureteric stones: Surgical technique, outcomes and literature review

The effects of pregabalin, solifenacin and their combination therapy on ureteral double-J stent-related symptoms: A randomized controlled clinical trial

The effect of music on state anxiety in patients undergoing extracorporeal shockwave lithotripsy

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