Cochrane · systematic review · CD007044
Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones
Setthawong, V, Srisubat, A, Potisat, S, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
UrologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 16.7%Low 5 · 41.7%Moderate 5 · 41.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
ESWL compared to PCNL for kidney stones
Population: people (>14 years) with kidney stones
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment success rate at 3 months MCID: 5% absolute difference ESWL vs PCNL | RR 0.67 [0.57, 0.79] | 12 studies · 1303 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Quality of life MCID for SF‐36 overall health score: 10 (scale 0 to 100; higher scores indicate better health status) ESWL vs PCNL | no estimate extracted | 1 study · 78 participants | Low Downgraded: risk of bias, imprecision |
Complications MCID: 3% absolute difference ESWL vs PCNL | RR 0.62 [0.47, 0.82] | 13 studies · 1385 participants | Moderate Downgraded: risk of bias |
Retreatment rate MCID: 3% absolute difference ESWL vs PCNL | RR 15.53 [6.62, 36.39] | 10 studies · 1174 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Auxiliary procedures rate MCID: 3% absolute difference ESWL vs PCNL | RR 4.17 [2.67, 6.52] | 8 studies · 1044 participants | Moderate Downgraded: risk of bias |
Duration of hospital stay MCID: 1 day absolute difference ESWL vs PCNL | no estimate extracted | 6 studies · 841 participants | Moderate Downgraded: risk of bias, inconsistency |
ESWL compared to RIRS for kidney stones
Population: people (>14 years) with kidney stones
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment success rate at 3 months MCID: 5% absolute difference ESWL vs RIRS | RR 0.85 [0.78, 0.93] | 13 studies · 1349 participants | Low Downgraded: risk of bias, inconsistency |
Quality of life MCID varies by instrument. ESWL vs RIRS | no estimate extracted | 3 studies · 214 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Complications MCID: 3% absolute difference ESWL vs RIRS | RR 0.93 [0.63, 1.36] | 13 studies · 1305 participants | Very low Downgraded: risk of bias, imprecision |
Retreatment rate MCID: 3% absolute difference ESWL vs RIRS | RR 6.78 [3.82, 12.04] | 9 studies · 1030 participants | Moderate Downgraded: risk of bias |
Auxiliary procedures rate MCID: 3% absolute difference ESWL vs RIRS | RR 1.98 [1.14, 3.47] | 5 studies · 836 participants | Low Downgraded: risk of bias, imprecision |
Duration of hospital stay MCID: 1 day of absolute difference ESWL vs RIRS | no estimate extracted | 3 studies · 591 participants | Moderate Downgraded: risk of bias, inconsistency |