Urol J. 2022 Jan 25. doi: 10.22037/uj.v19i.6946. Online ahead of print.
ABSTRACT
PURPOSE: Although extracorporeal shockwave lithotripsy (SWL) has been confirmed to be effective in treating ureteral stone, a definitive conclusion which patient’s position is optimal option during SWL treatment remains unclear. We therefore performed this updated meta-analysis to further clarify it.
MATERIALS AND METHODS: PubMed, Embase and Cochrane library were performed to capture all potentially eligible studies from their inception to October 2020. After screening eligible studies, extracting essential data, and assessing the risk of bias, we used STATA 14.0 to complete all statistical analyses.
RESULTS: We included 7 studies involving 8 cohorts in the final analysis. Our meta-analysis suggested that the prone position was inferior to supine position in terms of stone fragmentation and stone clearance rate after completing first treatment (95% CI: 0.30-0.63; OR = 0.44;), however subgroup analysis indicated that the difference between supine and prone positions for stone fragmentation and stone clearance rate was only getting statistical significance for distal ureteral stone (95% CI: 0.23-0.53; OR = 0.35). Moreover, subgroup analysis of two eligible randomized controlled trials suggested that the mean number of sessions per patient in the supine group was less than that in the prone group (95% CI: 0.11-0.48; WMD = 0.294). No major and severe complication was detected to be done with the association with positions.
CONCLUSION: SWL of the supine position may be the preferred option because this strategy can increase the distal ureteral stone-free rate compared to the prone position.
PMID:35075627 | DOI:10.22037/uj.v19i.6946
