Comparison of high, intermediate, and low frequency shock wave lithotripsy for urinary tract stone disease: Systematic review and network meta-analysis

Dong Hyuk Kang, Kang Su Cho, Won Sik Ham, Hyungmin Lee, Jong Kyou Kwon, Young Deuk Choi, Joo Yong Lee

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Objectives: To perform a systematic review and network meta-analysis of randomized controlled trials (RCTs) to determine the optimal shock wave lithotripsy (SWL) frequency range for treating urinary stones, i.e., high-frequency (100-120 waves/minute), intermediate-frequency (80-90 waves/minute), and low-frequency (60-70 waves/minute) lithotripsy. Materials and Methods: Relevant RCTs were identified from electronic databases for meta-analysis of SWL success and complication rates. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Outcome variables are provided as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Thirteen articles were included in the qualitative and quantitative synthesis using pairwise and network meta-analyses. On pairwise meta-analyses, comparable inter-study heterogeneity was observed for the success rate. On network meta-analyses, the success rates of low- (OR 2.2; 95% CI 1.5-2.6) and intermediate-frequency SWL (OR 2.5; 95% CI 1.3-4.6) were higher than high-frequency SWL. Forest plots from the network meta-analysis showed no significant differences in the success rate between low-frequency SWL versus intermediate-frequency SWL (OR 0.87; 95% CI 0.51-1.7). There were no differences in complication rate across different SWL frequency ranges. By rank-probability testing, intermediate-frequency SWL was ranked highest for success rate, followed by low-frequency and high-frequency SWL. Low-frequency SWL was also ranked highest for low complication rate, with high- and intermediate-frequency SWL ranked lower. Conclusions: Intermediate- and low-frequency SWL have better treatment outcomes than high-frequency SWL when considering both efficacy and complication.

Original languageEnglish
Article numbere0158661
JournalPloS one
Issue number7
Publication statusPublished - 2016 Jul

Bibliographical note

Publisher Copyright:
© 2016 Kang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

All Science Journal Classification (ASJC) codes

  • General


Dive into the research topics of 'Comparison of high, intermediate, and low frequency shock wave lithotripsy for urinary tract stone disease: Systematic review and network meta-analysis'. Together they form a unique fingerprint.

Cite this