SYSTEMATIC REVIEW article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1610470
This article is part of the Research TopicPrevention and Treatment of Urolithiasis: Innovation and Novel TechniquesView all 14 articles
Effectivity and Safety of Extracorporeal Shock Wave Lithotripsy or Retrograde Intrarenal Surgery Combined with Extracorporeal Physical Vibration for Stone Expulsion: A Meta-Analysis
Provisionally accepted
- 1Fujian Medical University, Fuzhou, China
- 2The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China, Xiamen, Fujian Province, China
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Purpose: This study aimed to evaluate whether Extracorporeal Physical Vibration Lithotripsy (EPVL) is effective and safe in enhancing the stone-free rate (SFR) after Extracorporeal Shock Wave Lithotripsy (ESWL) and Retrograde Intrarenal Surgery (RIRS).methods: A search of the literature from the inception of the databases to March 1, 2025, was conducted in PubMed, Web of Science, Embase, and the Cochrane Library . Randomized controlled trials (RCTs) comparing the efficacy of EPVL - assisted stone expulsion with traditional stone expulsion therapy in patients with upper urinary tract stones after lithotripsy were collected. Two researchers independently screened the literature, evaluated the studies, and extracted data. Any disagreements were resolved by a third senior researcher. The quality of the included studies was assessed, relevant data were extracted, and a meta - analysis was performed using RevMan 5.4 software.Results: A total of 9 controlled trials involving 1,418 patients were included. Compared with the control group, patients who received External Physical Vibration Lithecbole (EPVL) treatment (intervention group) had higher stone-free rates (SFRs) at 1 week (RR = 1.44, 95% CI: 1.18 - 1.77, P < 0.01) and 2 weeks (RR = 1.40, 95% CI: 1.20 - 1.63, P < 0.01) after surgery. The intervention group had higher SFRs in the lower calyx of the kidney (RR = 1.56, 95% CI: 1.25 – 1.96, P < 0.01) and renal pelvis (RR = 1.54, 95% CI: 1.10 – 2.14, P = 0.01). To some extent, this intervention played a positive role in reducing the incidence of complications (RR = 0.58, 95% CI: 0.46 - 0.73, P < 0.01). It had a positive effect on urinary tract infections (RR = 0.28, 95% CI: 0.14 - 0.57, P < 0.01) and hematuria (RR = 0.64, 95% CI: 0.48 - 0.86, P < 0.01). Conclusion: EPVL may serve as a safe and effective adjunct to ESWL or RIRS, particularly for lower calyx and renal pelvis stones, to accelerate early clearance and reduce short-term complications.
Keywords: external physical vibration lithotripsy, Upper urinary tract stones, Stone free rate, complications, Meta-analysis
Received: 12 Apr 2025; Accepted: 06 Jun 2025.
Copyright: © 2025 Huang, Huang, Zhang, Xie, Wang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tao Wang, The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China, Xiamen, Fujian Province, China
Yuedong Chen, Fujian Medical University, Fuzhou, China
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