📃 Paper Title: Treatment of Bladder Stones in Adults and Children: A Systematic Review and Meta-analysis on Behalf of the European Association of Urology Urolithiasis Guideline Panel
🧍 Author: Donaldson
🕒 Year: 2019
📚 Journal: European Urology
🌎 Country: United Kingdom
ㅤContext to the study:
Can you tell me about a study that assessed the efficacy of endoscopic surgery versus open surgery in bladder stone treatment?
ㅤ✅ Take-home message of study:
Endoscopic surgery such as Transurethral cystolithotripsy (TUCL) and Percutaneous cystolithotripsy (PCCL) are equally as effective as open surgery in bladder stone treatment
TUCL is the preferred choice of intervention for bladder stones whenever feasible as it is minimally invasive and associated with low complication rates & reduced length of hospital stay.
This paper highlights the need for further research comparing the treatment modalities of bladder stones in children given its limited evidence base
ㅤ Systematic review & meta analysis
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Study participants:
Study Size:
2340 patients from 25 studies (9 RCTs) 1526 adults & 814 children
Study inclusion criteria:
Studies that reported the treatment of BS in adults and/or children
Studies that evaluated one or more of the treatment options for bladder stones such as TCL, PCCL, open surgery, shock-wave lithotripsy (SWL)
Studies that reported clinical outcomes such as stone-free rates, complication rates or hospital length of stay
Patient inclusion criteria:
Male, female adults and children
Patient with ≥ 1 bladder stone
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Key study outcomes:
**Stone-free rate: **
1 RCT found a lower SFR following SWL than TUCL in adults (RR=0.88, P=0.03).
4 RCTs compared TUCL against PCCL but found no difference in SFR for adults
4 non-randomised studies (NRS) comparing open surgery vs endoscopic surgery (TUCL or PCCL) found no difference in SFR in adults
1 NRS showed a lower SFR following SWL compared to TUCL or cystolithotomy (CL)
Length of hospital stay:
4 RCTs compared TUCL vs PCCL and favoured TUCL in hospital stay & procedure duration (both p<0.00001)
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Study Limitations:
Limitations:
Limited duration for long-term follow-up (only 1 RCT with 24-month follow-up)
Inclusion of several non-randomised studies which may cause a greater risk of bias.
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