Does previous unsuccessful shockwave lithotripsy influence the outcomes of ureteroscopy?-a systematic review and meta-analysis.

BACKGROUND

To determine whether previous unsuccessful shockwave lithotripsy (SWL) influence the outcomes of ureteroscopy (URS).

METHODS

An exhaustive search of PubMed, EMBASE, Web of Science and Cochrane Library were conducted to find eligible studies before October 2020. Result variables consisting stone-free rate (SFR), operation time and postoperative modified Clavien grade I-IV complications were pooled utilizing RevMan 5.3.

RESULTS

Seven studies with 2413 individuals were included. Pooled results revealed that the salvage URS after failed SWL was similar to URS performed primarily regarding SFR [odds ratio (OR) =0.84, P=0.15] and operation time [weighted mean difference (WMD) =6.79, P=0.19]. Additionally, no statistically significant differences concerning fever (OR: 1.36; P=0.32), hematuria (OR: 0.81; P=0.75), urinary tract infection (OR: 1.57; P=0.28), renal colic (OR: 1.94; P=0.50), ureteral perforation (OR: 1.44; P=0.46), ureteral avulsion (OR: 1.21; P=0.83), stone migration (OR: 0.92; P=0.86) and sepsis (OR: 0.46; P=0.38) were observed between salvage URS and primary URS group.

DISCUSSION

The success rates and complications of URS were not impacted by previous unsuccessful SWL. The salvage URS is equally effective and safe to primary URS.