What do systematic reviews say?

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

Percutaneous nephrolithotomy may leads to higher stone‐free rate Assumed MCID: 5% compared with retrograde intrarenal surgery (low certainty).

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  RR 1.13 [1.08, 1.18]
  39 studies · 4088 participants
  Low

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

Percutaneous nephrolithotomy showed no clear difference in major complications Assumed MCID: 2% compared with retrograde intrarenal surgery (moderate certainty).

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  RR 0.86 [0.59, 1.25]
  34 studies · 3649 participants
  Moderate

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

Percutaneous nephrolithotomy may leads to lower need for secondary interventions Assumed MCID: 5% compared with retrograde intrarenal surgery (low certainty).

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  RR 0.31 [0.17, 0.55]
  21 studies · 2005 participants
  Low

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

The review found no eligible studies for this question.

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  no estimate extracted
  26 studies · 2804 participants
  Low

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

Percutaneous nephrolithotomy showed no clear difference in ureteral stricture or injury Assumed MCID: 2% compared with retrograde intrarenal surgery (low certainty).

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  RR 0.93 [0.39, 2.21]
  13 studies · 1574 participants
  Low

Percutaneous nephrolithotomy vs retrograde intrarenal surgery

The review found no eligible studies for this question.

• Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Systemic TXA vs placebo or usual care

Systemic TXA probably leads to lower blood transfusion compared with no TXA (placebo or usual care) (moderate certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 0.45 [0.27, 0.76]
  9 studies · 1353 participants
  Moderate

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA probably leads to lower blood transfusion compared with no TXA (placebo or usual care) (moderate certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 0.4 [0.2, 0.81]
  1 study · 400 participants
  Moderate

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA showed no clear difference in stone‐free rate compared with no TXA (placebo or usual care) (low certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 1.07 [0.99, 1.17]
  1 study · 400 participants
  Low

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA showed no clear difference in thromboembolic events compared with no TXA (placebo or usual care) (moderate certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RD 0
  1 study · 400 participants
  Moderate

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA showed no clear difference in adverse event compared with no TXA (placebo or usual care) (moderate certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RD 0
  1 study · 400 participants
  Moderate

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA showed no clear difference in major surgical complications compared with no TXA (placebo or usual care) (low certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 0.69 [0.45, 1.06]
  1 study · 400 participants
  Low

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

Topical TXA may leads to lower minor surgical complications compared with no TXA (placebo or usual care) (low certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 0.73 [0.59, 0.91]
  1 study · 400 participants
  Low

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs placebo or usual care

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 400 participants
  Moderate

Systemic TXA vs placebo or usual care

Systemic TXA showed no clear difference in stone‐free rate compared with no TXA (placebo or usual care) (low certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 1.11 [0.98, 1.27]
  4 studies · 603 participants
  Low

Systemic TXA vs placebo or usual care

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  0
  6 studies · 841 participants
  Moderate

Systemic TXA vs placebo or usual care

Systemic TXA showed no clear difference in adverse events compared with no TXA (placebo or usual care) (low certainty).

• Tranexamic acid for percutaneous nephrolithotomy 2023 · Cochrane Headline outcomes only
  RR 5.22 [0.52, 52.72]
  4 studies · 602 participants
  Low