A meta-analysis and systematic review of holmium laser treatment of bladder stones

Transl Androl Urol. 2021 Aug;10(8):3465-3475. doi: 10.21037/tau-21-563.

Abstract

Background: Holmium lasers have been used to treat bladder stones and achieve good therapeutic effects, but its efficacy remains to be explored.

Methods: The PubMed, Embase, Medline, Ovid, Springer, and Web of Sciences databases were searched from their establishment to December 31, 2020. Studies of randomized control trials (RCTs) examining the treatment of vesical calculi by holmium laser lithotripsy were identified. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was used to assess risk bias, and Rev Man5.3 was used to conduct the meta-analysis.

Results: A total of 10 studies, comprising 1,642 subjects, were included. The meta-analysis results showed that the surgery time and the hospitalization time of patients treated with holmium laser lithotripsy decreased, and the calculus removal rate increased. The experimental group had a lower incidence of adverse reactions, such as postoperative urinary tract infection, mucosal damage, vesical perforation, residual calculi, hematuria, and abdominal pain than the control group; however, no notable difference was observed in relation to surgery time, hospital stay, the calculus removal rate, mucosal damage, bladder perforation, hematuria, and abdominal pain between the 2 groups.

Discussion: Holmium laser lithotripsy significantly reduced the hospitalization time of patients treated with holmium laser lithotripsy and elevated the removal rate.

Keywords: Holmium laser lithotripsy; clinical efficacy; pneumatic lithotripsy; urological diseases; vesical calculi.