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Meta-Analysis
. 2021 Dec 31;21(1):448.
doi: 10.1186/s12893-021-01461-3.

Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

Liping Gou  1 , Zhenghao Wang  1 , Ye Zhou  1 , Xiaofeng Zheng  2
Affiliations
Meta-Analysis

Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

Liping Gou et al. BMC Surg. .

Abstract

Background: A systematic review and meta-analysis was conducted to compare the safety and efficiency of nephroscopy and cystoscopy in transurethral cystolithotripsy (TUCL) for bladder stones (BS).

Methods: The PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases were searched up to January 2021 for studies assessing the effect of different types of endoscopes among patients who underwent TUCL. The search strategy and study selection process were in accordance with the PRISMA statement.

Results: Five randomized controlled trials were included in the meta-analysis. The results showed no difference in stone-free rate (RR = 1.00, CI = 0.98-1.02, p = 1.00) between the two groups and nonsignificant heterogeneity (I2 = 0%, p = 1.00), and all patients were rendered stone free. Use of the nephroscope significantly shortened the operative time compared with the cystoscope group (RR= - 26.26, CI = - 35.84 to - 16.68, p < 0.00001), and there was significant heterogeneity (I2= 87%, p < 0.00001). There was no significant difference in mean urethral entries (RR = 0.66, CI = - 0.71 to - 2.04, p = 0.35), hospitalization (MD = 0.08, 95% CI = - 0.07 to 0.23, p = 0.31) or total complication rate (RR=1.37, 95% CI = 0.47-4.00, p = 0.56) between the two groups.

Conclusions: In conclusion, this systematic review demonstrates that both nephroscopy and cystoscopy have high stone clearance efficiency, low rates of complications and short hospitalizations. The mean urethral entries depend on the treatment method for large stone fragments. However, the use of nephroscopy can significantly reduce the operative time.

Keywords: BS; Cystoscope; Endoscopic treatments; Nephroscope; Transurethral.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study search and selection process
Fig. 2
Fig. 2
Forest plot for primary outcomes: a stone clearance. b Operation time
Fig. 3
Fig. 3
Forest plot for secondary outcomes: a mean urethral entries. b Hospitalization. c Total complications
See this image and copyright information in PMC

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