scholarly journals Did we take physical therapy serious after lithotripsy: a meta-analysis of prospective studies

2019 ◽  
Author(s):  
Linjie Peng ◽  
Junjun Wen ◽  
Guohua Zeng ◽  
Wen Zhong
Keyword(s):  
Physical Therapy ◽  
Prospective Studies ◽  
Large Scale ◽  
Randomized Study ◽  
Medical Intervention ◽  
Cochrane Library ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate

Abstract Background Stone-free rate (SFR) after lithotripsy was one of the most frequent concerned issue, especially in patients following extracorporeal shockwave lithotripsy (ESWL) and flexible ureteroscopy (retrograde intrarenal surgery, RIRS). Physical therapy including percussion, inversion, physical vibration and their combinations was administrated to improve the SFR, but there was no conclusive evidence to support this theory. To conclude the effectiveness and safety of physical therapy on the SFR in patients received ESWL/RIRS. Methods We systematically reviewed the literature focused on physical therapy in patients after ESWL/RIRS on PubMed, Scopus, Cochrane library and Embase from 2000 to 2019 April. We mainly focused on stone-free rate and complications rate. Results Nine prospective studies including 8 randomized control trials and 1 non-randomized study were enrolled, and 1747 subjects were analyzed. All the physical therapy we enrolled was finally concluded into EPVL (external physical vibration lithecbole) and PDI (percussion, diuresis and inversion). Compared to conventional group, physical therapy provided a higher SFR (OR: 2.68; 95% CI: 1.74–4.12; P = 0.0001), especially SFR in lower calyx stones (OR: 3.60; 95% CI: 2.26-5.73; P= 0.0001). In subgroup analysis, EPVL (OR: 2.28; 95% CI: 1.27–4.07; P =0.005) and PDI (OR: 3.51; 95% CI: 1.96–6.26; P = 0.0001) were both effective. Drinking e enough water before treatment was supposed to increase the SFR (OR: 3.31; 95% CI: 2.39–4.60; p = 0.0001). Otherwise, medical intervention such as furosemide (OR: 5.21; 95% CI: 0.53–50.72; P = 0.156) and tamsulosin (OR: 1.05; 95% CI: 0.61–1.82; P = 0.855) did not improve the SFR. No significant difference was detected in terms of complications rates (OR: 0.83; 95% CI: 0.61–1.14; P = 0.25). Conclusions EPVL or PDI were both effective and safe in increasing the SFR after ESWL/RIRS, but its effectiveness was limited in LCS. Drinking enough water before physical therapy helped to improve the SFR. The role of furosemide and tamsulosin in physical therapy or surgery need to be testified by large-scale, high-quality studies.

The Outcomes of Pre-Stenting on Renal and Ureteral Stones: A Meta-Analysis

2021 ◽  
pp. 1-9
Author(s):  
Han Chen ◽  
Yang Pan ◽  
Min Xiao ◽  
Jingruo Yang ◽  
Yong Wei
Keyword(s):  
Operative Time ◽  
Meta Analysis ◽  
Renal Stones ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteroscopic Lithotripsy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Meta Analyses ◽  
Free Rate

<b><i>Background:</i></b> Pre-stenting (PS) on the outcomes of semirigid and flexible ureteroscopic lithotripsy for a different upper urinary urolithiasis remains controversial. We performed a meta-analysis comparing the outcomes of ureteroscopic lithotripsy between PS and non-PS. <b><i>Materials and Methods:</i></b> Randomized, controlled trials and observational studies comparing PS and non-PS were identified from electronic databases. Stone-free rate (SFR), operative time, and complications were compared by qualitative and quantitative syntheses (meta-analyses). <b><i>Results:</i></b> Eleven articles were included in this study. Nearly, all of recently published studies exhibited relatively moderate or high quality during quality assessment. PS was more likely to achieve good SFR compared with non-PS (<i>p</i> &#x3c; 0.00001). The subgroup results indicated that PS improved the SFR for renal stones and the stones dealt by flexible ureteroscopy (<i>p</i> = 0.0002; <i>p</i> &#x3c; 0.0001, respectively; some ureteral stones were dealt by flexible ureteroscopy). Ureteral stones and the stones dealt by semirigid ureteroscopy were not influenced by PS (<i>p</i> = 0.62; <i>p</i> = 0.90, respectively). PS is equal as non-PS in terms of operative time for renal stones and the renal and ureteral stones dealt by flexible ureteroscopy (<i>p</i> = 0.47; <i>p</i> = 0.05). No significant difference was found in major complications between the 2 groups for total or for the subgroup of renal stones (<i>p</i> = 0.3; <i>p</i> = 0.69). <b><i>Conclusions:</i></b> For ureteral stones or the stones dealt by semirigid ureteroscopy, PS does not show any benefits. For renal stones or the stones dealt by flexible ureteroscopy, PS improves the SFR and may be as safe as non-PS.

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

2014 ◽  
Vol 94 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Chen Xu ◽  
Ri-jin Song ◽  
Min-jun Jiang ◽  
Chao Qin ◽  
Xiao-lan Wang ◽  
...  
Keyword(s):  
Renal Stones ◽  
Laser Lithotripsy ◽  
Flexible Ureteroscopy ◽  
Stone Fragment ◽  
Stone Burden ◽  
Holmium Laser Lithotripsy ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Free Rate ◽  
Free Status

Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.

scholarly journals Did we take physical therapy serious after ESWL and retrograde intrarenal surgery

2020 ◽  
Author(s):  
Linjie Peng ◽  
Junjun Wen ◽  
Guohua Zeng ◽  
Wen Zhong
Keyword(s):  
Physical Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Review Of Literature ◽  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Randomized Control ◽  
And Inversion ◽  
Free Rate

Abstract Background: Physical therapy, including percussion, inversion, vibration and combinations, was clinically administrated to improve the stone-free rate (SFR). The present study aimed to investigate the role of physical after ESWL and retrograde intrarenal surgery (RIRS).Methods: Systematic review of literature from PubMed, Scopus, Cochrane library and Embase which focused on physical therapy after ESWL and RIRS was administrated, meta-analysis was performed, SFR and complications was investigated.Results: A total of 8 prospective studies with 1065 patients were enrolled, including 7 randomized control trials and 1 prospective study. 1 study was designed on RIRS and the rest 7 studies were on ESWL. Compared to observation group, physical therapy provided a higher SFR (OR= 3.38, 95% CI: 2.45-4.66, p< 0.0001) at any time point (week1, week2 and month1), especially the SFR in lower calyceal stone (OR: 3.51; 95%CI: 2.21-5.55; p<0.0001) and upper ureteral stone (OR:2.79; 95%CI:1.62-4.81; p=0.0002). In subgroup analysis, EPVL (external physical vibration lithecbole, OR:3.47; 95%CI:2.24-5.37; p<0.0001) and PDI (percussion, diuresis and inversion, OR:3.24; 95%CI:2.01-5.21; p<0.0001) were both effective. Complications such as hematuria, lumbago, dizziness and urinary tract infection were all comparable (OR: 0.84; 95% CI: 0.62-1.13; p = 0.237). Conclusions: Physical therapy was effective and safe in increasing the SFR after ESWL and RIRS without significant side effects, especially for lower calyceal stone and upper ureteral or renal pelvic stone. A consistent protocol for physical therapy after lithotripsy was needed to be built, which would promote a better final stone-free. And the role of drinking enough water, furosemide and tamsulosin in physical therapy required further test. Review Registration: PROSPERO 2019 CRD42019130228.

Factors that affect Stone Free Rate in flexible ureteroscopy in large renal calculi lithotripsy

2018 ◽  
Vol 17 (4) ◽  
pp. e2016
Author(s):  
G. Dellis ◽  
E. Patili ◽  
J. Varkarakis ◽  
A. Papatsoris ◽  
M. Berdebes ◽  
...  
Keyword(s):  
Renal Calculi ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2728 ◽  
Author(s):  
Jiaqiao Zhang ◽  
Chuou Xu ◽  
Deng He ◽  
Yuchao Lu ◽  
Henglong Hu ◽  
...  
Keyword(s):  
Renal Stone ◽  
Operation Time ◽  
Renal Stones ◽  
Renal Calculi ◽  
Good Prognosis ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Ureteral Stenting ◽  
Free Rate

Purpose To clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting. Methods A total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups. Results Successful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969). Conclusions fURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

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