SynthesisMedicine2020
Comparison of the efficacy and safety of shockwave lithotripsy, retrograde intrarenal surgery, percutaneous nephrolithotomy, and minimally invasive percutaneous nephrolithotomy for lower-pole renal stones: A systematic review and network meta-analysis.
Synthesis in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Percutaneous nephrolithotomy versus retrograde intrarenal surgery for treatment of renal stones in adults.The Cochrane database of systematic reviews · 2023Pooled it
- Pooled it
- Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.The Cochrane database of systematic reviews · 2023Pooled it
- RIRS vs PCNL in treating lower-pole renal stones: a comparative clinical outcome study.Future science OA · 2026Article
- Evaluation of the predictive accuracy of scoring systems for retrograde intrarenal surgery in a pediatric population.BMC urology · 2026Article
- Efficacy and safety of ureteroscopy in children with lower pole renal stones : a machine learning predictive model from the EAU section of endourology.World journal of urology · 2025Article
- Article
- Article
- A randomized comparative study of flexible ureterorenoscopy versus mini-percutaneous nephrolithotomy for treatment of renal stones 2 cm or less.Current urology · 2024Article
- New infundibulopelvic angle measurement method can predict stone-free rates following retrograde intrarenal surgery.Scientific reports · 2024Article
- Endourological Options for Small (< 2 cm) Lower Pole Stones - Does the Lower Pole Angle Matter?Current urology reports · 2023Review
- Article
- Comparative study between ultra-mini-percutaneous nephrolithotomy versus stented extracorporeal shock wave lithotripsy for treatment of renal stones in Egypt.Arab journal of urology · 2023Article
- The effect of percussion, diuresis and inversion therapy on RIRS success for lower renal pole stones.Central European journal of urology · 2023Article
- A Comparative Study of Stone Re-Treatment after Lithotripsy.Life (Basel, Switzerland) · 2022Article
- Article
- Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study.World journal of urology · 2022Observational
- The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years.Journal of clinical medicine · 2021Article
- Retrograde intrarenal surgery versus percutaneous nephrolithotomy in larger kidney stones. Could SuperPulsed Thulium-fiber laser change the game?Central European journal of urology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), and minimally invasive PCNL are currently therapeutic options for lower-pole renal stones (LPS). However, the optimal treatment for LPS remains unclear. A comprehensive evaluation of the efficacy and safety of each intervention is needed to inform clinical decision-making. This study aimed at assessing the efficacy and safety of different interventions for LPS.
methodsPubMed, Embase, ScienceDirect, ClinicalKey, Cochrane Library, ProQuest, Web of Science, and ClinicalTrials.gov were searched from inception to December 6th 2018. Only randomized controlled trials (RCTs) including the patients treated for LPS were included. The frequentist models of network meta-analysis were used to compare the effect sizes. The primary outcome was stone free rate, and the secondary outcomes were overall complication rate, major complication rate, retreatment rate, and auxiliary procedure rate.
resultsThis study included 13 RCTs comprising 1832 participants undergoing 6 different interventions, including RIRS, PCNL, Mini-PCNL, Micro-PCNL, SWL, and conservative observation. PCNL had the best stone free rate (odds ratio [OR] = 3.45, 95% confidence interval [CI] = 1.30-9.12), followed by Mini-PCNL (OR = 2.90, 95% CI = 1.13-7.46). Meta-regression did not find any association of the treatment effect with age, sex, and stone size. Although PCNL tended to exhibit a higher complication rate, the difference of complication rate among various interventions did not achieve a statistical significance. SWL was the less effective and associated with higher retreatment rate compared with PCNL, Mini-PNCL, and RIRS.
conclusionsPCNL was associated with the best stone free rate for LPS regardless of age, sex, and stone size. Each treatment achieved a similar complication rate compared with the others. Future large-scale RCTs are warranted to identify the most beneficial management for renal stones at a more complicated location.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.