The Efficacy of Flexible Ureterorenoscopy Compared with Extracorporeal Shock Wave Lithotripsy for <20 mm Renal Stone: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
ABSTRACT Introduction: Renal stone is a common urological problem that has increased over the years. Extracorporeal shock wave lithotripsy (ESWL) is a noninvasive treatment for patients with <20 mm renal stones, but it also has a lower stone-free rate (SFR) and a higher re-treatment rate (RR) compared to other modalities. On the other hand, flexible ureterorenoscopy (F-URS) can be used to manage larger renal stones and is associated with higher SFR. Thus, we created this study to assess the efficacy and safety of F-URS versus ESWL for patients with <20 mm renal stones. Methods: This systematic review and meta-analysis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and used PICO analysis to systematically search the included studies from several databases, such as PubMed and ScienceDirect. Sixteen relevant studies were included for qualitative and quantitative analysis. Cochrane risk-of-bias tool for randomized trials (RoB) 2.0 was used as bias analysis for RCT studies and the Newcastle-Ottawa Scale for observational studies. Results: A total of 2487 patients were included in this study. The SFR was significantly higher in the F-URS group ( P < 0.00001), while the auxiliary procedure was significantly higher in the ESWL group ( P < 0.00001). However, neither significant difference was observed in the mean operative time, RR Clavien–Dindo classification, and complication rate-based symptom outcomes in both the groups. Conclusion: F-URS and ESWL are safe and effective in treating <20 mm renal stones. In terms of SFR, F-URS is superior compared to ESWL. However, a lower complication rate was observed in ESWL.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.028 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.048 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".