The Meta analysis of the effect of extracorporeal shock wave lithotripsy and ureteroscopy in the treatment of urethral stone

Objective: To evaluate the effects of the extracorporeal shock wave lithotripsy(ESWL) and ureteroscopy(URS) in the treatment of urethral stone.Methods: The data of the randomized controlled trials of ESWL and ureteroscopy in the treatment of urethral stone from the Cochrane Central Register of Controlled Trials(CENTRAL in The Cochrane Library Issue 9,2012),CNKI,PubMed,EMbase,BIOSIS,International Pharmaceutical Abstracts,reference lists of articles and abstracts from conference proceedings were collected from Mon 1990 to Sep 2012,and which was evaluated and analyzed by two authors using RevMan5.1 software.Results: Nine randomized controlled trials(1399 patients) were investigated.The results of meta-analysis showed that the stone-free rate of URS was better than that of ESWLOR=0.29,95%CI(0.14,0.57)(P<0.01),but the re-treatment rate of ESWL after operation was higher than that of URSOR=8.07,95%CI(5.23,12.46)(P<0.01).The auxiliary treatment rate of URS after operation was higher than that of ESWLOR=0.29,95%CI(0.13,0.62),I²=70%)(P<0.01).The procedure-related complications of URS were higher than that of ESWLOR=0.42,95%CI(0.21,0.84)(P=0.01),but its post-operation complications were lowerOR=0.24,95%CI(0.12,0.50)(P<0.01),I²=0%.The length of hospital stay of ESWL was shorter than that of URSOR=-2.55,95%CI(-3.24,1.86)(P<0.01).Conclusions: The choice of treatment for urethral stone should accord to the existing equipment,location and size of urethral stone,and which need the further verification of randomized controlled trials.