Effects of diuretic administration on outcomes of extracorporeal shockwave lithotripsy: A systematic review and meta-analysis. 2020

Zhenghao Wang, and Yunjin Bai, and Jia Wang
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.

The present systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted for investigating the effect of diuretics on the outcomes of shockwave lithotripsy (SWL) for the treatment of urinary stones. We performed searches of PubMed, Web of science, Embase, EBSCO, and Cochrane library databases from inception to November 2019. RCTs were selected for assessing the effects of diuretics on fragmentation and clearance of urinary stones. The search strategy and study selection process were performed in accordance with the PRISMA guidelines. Four RCTs were included in the meta-analysis. Overall, intervention groups experienced significant improvements in fragmentation compared with the control groups (risk ratio [RR] = 1.14, 95% confidence interval [CI] = 1.05-1.03, P = 0.02). However, stone clearance did not significantly differ between the intervention and control groups (RR = 1.23, 95% CI = 0.97-1.56, P = 0.08). The total numbers of shocks and sessions required were significantly reduced by the use of diuretics. Diuretics significantly enhance stone fragmentation for patients undergoing SWL. However, the improvement in stone clearance appears to be insignificant.

UI MeSH Term Description Entries
D008096 Lithotripsy The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is LITHOTRIPSY, LASER. ESWL (Extracorporeal Shockwave Lithotripsy),Electrohydraulic Shockwave Lithotripsy,Extracorporeal Shockwave Lithotripsy,Litholapaxy,Noninvasive Litholapaxy,Percutaneous Ultrasonic Lithotripsy,Ultrasonic Lithotripsy,ESWLs (Extracorporeal Shockwave Lithotripsy),Electrohydraulic Shockwave Lithotripsies,Extracorporeal Shockwave Lithotripsies,Litholapaxies,Litholapaxies, Noninvasive,Litholapaxy, Noninvasive,Lithotripsies,Lithotripsies, Electrohydraulic Shockwave,Lithotripsies, Extracorporeal Shockwave,Lithotripsies, Percutaneous Ultrasonic,Lithotripsies, Ultrasonic,Lithotripsy, Electrohydraulic Shockwave,Lithotripsy, Extracorporeal Shockwave,Lithotripsy, Percutaneous Ultrasonic,Lithotripsy, Ultrasonic,Noninvasive Litholapaxies,Percutaneous Ultrasonic Lithotripsies,Shockwave Lithotripsies, Electrohydraulic,Shockwave Lithotripsies, Extracorporeal,Shockwave Lithotripsy, Electrohydraulic,Shockwave Lithotripsy, Extracorporeal,Ultrasonic Lithotripsies,Ultrasonic Lithotripsies, Percutaneous,Ultrasonic Lithotripsy, Percutaneous
D004232 Diuretics Agents that promote the excretion of urine through their effects on kidney function. Diuretic,Diuretic Effect,Diuretic Effects,Effect, Diuretic,Effects, Diuretic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000074059 Extracorporeal Shockwave Therapy A nonsurgical treatment that uses either HIGH-ENERGY SHOCK WAVES or low energy ACOUSTIC WAVES to treat various musculoskeletal conditions (e.g., PLANTAR FASCIITIS; TENNIS ELBOW). A probe placed on the skin conducts the shock waves thereby delivering a mechanical force to the body’s tissues. Extracorporeal High-Intensity Focused Ultrasound Therapy,Extracorporeal Shock Wave Therapy,HIFU Therapy,High-Intensity Focused Ultrasound Therapy,Shock Wave Therapy,Extracorporeal High Intensity Focused Ultrasound Therapy,Extracorporeal Shockwave Therapies,HIFU Therapies,High Intensity Focused Ultrasound Therapy,Shock Wave Therapies,Shockwave Therapies, Extracorporeal,Shockwave Therapy, Extracorporeal,Therapy, Extracorporeal Shockwave,Therapy, HIFU,Therapy, Shock Wave
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D052878 Urolithiasis Formation of stones in any part of the URINARY TRACT, usually in the KIDNEY; URINARY BLADDER; or the URETER. Urinary Lithiasis,Lithiasis, Urinary

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