Percutaneous nephrolithotomy versus ureteroscopic lithotripsy for ureteral calculi therapy: a meta-analysis

Background: The present study aimed to explore the efficacy of percutaneous nephrolithotomy versus ureteroscopic lithotripsy, systematically, in the treatment of ureteral calculi. Methods: PubMed, Cochrane, and Embase databases, updated to September 2017, were searched by index words to identify relevant studies, including qualified randomized controlled studies or comparison studies. Studies were also identified by tracking reference lists from papers and internet searches. This meta-analysis was performed using mean difference (MD), odds radio (OR), and 95% confidence interval (95% CI) to analyze main outcomes. Results: A total of 12 studies were included in this meta-analysis, with 649 subjects in the PCNL group and 633 subjects in the URSL group. Results indicated that PCNL significantly increased hospital stays (SMD, 2.13; 95% CI 1.46-2.80), stone-free rates (3 days) (OR, 6.70; 95% CI 2.61-17.17), and other stone-free rates (1 month) (OR, 4.59; 95% CI 3.02-6.97), compared to the URSL group. However, there were no significant differences in operation times (WMD, 14.09; 95% CI: -0.76-28.94) and complications (OR, 1.25; 95% CI 0.71-2.20) between the two groups. Conclusion: Favorable outcomes regarding stone-free rates of 3 days and 1 month were identified in the PCNL group, compared to the URSL group, but URSL significantly decreased hospital stays. More high quality studies are required to confirm the efficacy of PCNL and URSL in identifying the best therapy for ureteral calculi.