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- Title
Effect of mechanical percussion combined with patient position change on the elimination of upper urinary stones/fragments: a systematic review and meta-analysis.
- Authors
Zeng, Tao; Tiselius, Hans-Göran; Huang, Jian; Deng, Tuo; Zeng, Guohua; Wu, Wenqi
- Abstract
The objective of this study is to explore the efficacy and safety of mechanical percussion combined with changed patient position (MPPP) on elimination of residual stones/fragments in the upper urinary tract. The study was a systematic review and meta-analysis. A systematic literature review using Pubmed, Embase, Medline, and Cochrane Library was conducted to obtain randomized-controlled trials (RCTs) evaluating the efficacy and safety of MPPP treatment of patients with residual stones/fragments in the upper urinary tract. The retrieval of data ended in October 2018. Statistical analysis was carried out using summarized unadjusted risk ratios (RRs) with 95% confidence intervals (CIs). Seven RCTs comprising 1132 patients were included. Compared with patients in the control group, patients treated with MPPP had higher stone-free rates (SFRs) with RR 1.55 (CI 1.11–2.18; p = 0.01) and lower complication rates with RR 0.48 (CI 0.25–0.94, p = 0.03). In subgroup analysis based on stone location, the SFR for the lower calyx was significantly higher in the intervention group than in the control group: RR 1.80 (CI 1.47–2.21, p < 0.00001). In subgroup analysis based on complication type, compared with the control patients, the intervention patients had lower hematuria rate with RR 0.46 (CI 0.28–0.74, p = 0.001) and lower leucocyturia rate with RR 0.33 (CI 0.12–0.89, p = 0.03). MPPP is a worthwhile non-invasive method for elimination of residual stones/fragments in the upper urinary tract. Furthermore, we recommend MPPP for patients with residual stones or fragments located in the lower calyces.
- Subjects
META-analysis; PATIENT positioning; URINARY organs; URINARY calculi
- Publication
Urolithiasis, 2020, Vol 48, Issue 2, p95
- ISSN
2194-7228
- Publication type
Article
- DOI
10.1007/s00240-019-01140-2