Is extracorporeal shock wave lithotripsy a current treatment for urolithiasis? A systematic review.
BACKGROUND
Technological advances have prompted a change in the management of urolithiasis. Endourological techniques are gaining importance because they are highly effective treatments. The aim of this study was to answer the question of whether extracorporeal shock wave lithotripsy (ESWL) is still a competitive alternative compared with other therapeutic modalities.


METHODS
We conducted a literature search of articles published in the past 5 years. We identified 12 randomized and comparative studies and assessed the methodology and results of the study variables. We performed a narrative synthesis of the included studies. To summarise the variables, we used the mean and standard deviation for continuous variables and absolute numbers and percentages for the qualitative variables.
Of the studies reviewed, 7 evaluated the various treatments for nephrolithiasis and 5 evaluated the treatments for ureteral lithiasis. At the renal level, a stone-free rate of 33.33-91.5% at 3 months was reached with ESWL, while a rate of 90.4-100% was achieved with the other endourological techniques, without finding statistically significant differences in the studies. At the ureteral level, a stone-free rate of 73.5-82.2% at 3 months was reached with ESWL, while a rate of 79-94.1% was achieved with the other endourological techniques, without finding statistically significant differences in the studies.


CONCLUSIONS
There is a lack of homogeneity among the published studies. ESWL is a minimally invasive treatment that with an appropriate technique and patient selection achieves high effectiveness, thus maintaining an important role at this time.
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: pilarbahilo@hotmail.com.
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Bahílo Mateu
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
A
A
Budía Alba
Universidad de Patras, Patras, Grecia.
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E
Liatsikos
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
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M
Trassierra Villa
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
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López-Acón
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
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D
de Guzmán Ordaz
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
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F
Boronat Tormo
D006801:Humans; D008096:Lithotripsy; D052878:Urolithiasis / Q000628:therapy*
Endourology; Endourología; Extracorporeal lithotripsy; Lithiasis; Litiasis; Litotricia extracorpórea; Tratamiento; Treatment