Ureteroscopic lithotripsy compared with extracorporeal shockwave lithotripsy in the treatment of urolithiasis

Urolithiasis is a common and frequently occurring disease with high recurrence rate. Ureteroscopic lithotripsy (URSL) and extracorporeal shock wave lithotripsy (ESWL) are two most popular modalities in the treatment of urolithiasis. The efficacy of these two methods is reviewed on the treatment of ureteral stones in this systematic review.
PubMed was searched for the relevant randomized control trials (RCTs). Stone-free rate and retreatment rate were extracted from each article as the main outcomes, and Odds ratio was reported in each study.
Based on calculated odds ratio of each article, URSL has an odds ratio of 1 for the event of retreatment rate compared with ESWL.
Performing URSL in the treatment of urolithiasis could be associated with higher stone-free rate and lower retreatment rate; however duration of the surgery seems to be longer during URSL compared with ESWL.
There was high discrepancy between included RCTs regarding the study design, stone location, types of ureteroscope, intracorporeal lithotripsy devices, time to follow-up, and surgeon experience, which might affect the decision regarding type of surgery.