The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis

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This study compared the effectiveness of totally ultrasound-guided (US-guided) and fluoroscopy-guided (FS-guided) SWL in treating renal and ureteral stones. A protocol has been registered in PROSPERO databases for systematic reviews. A systematic literature search was conducted in five online databases (PubMed, ScienceDirect, EMBASE, ProQuest, and Scopus). We included all available articles that compared the effectiveness and safety of US-SWL to FS-SWL. A risk of bias assessment was done using Risk of Bias (Rob) Tools for randomized interventional studies and Risk of bias in non-randomized studies interventions (ROBINS-I) Tools for Non-randomized studies. The primary outcome was the stone-free rate, and the secondary outcome was the complication rate. Subgroup analyses were performed for adult and pediatric groups. A comprehensive literature search identified seven comparative articles that matched the criteria: two randomized trials and six retrospective cohort studies comprising 1,255 patients (609 using US-SWL). The results revealed a significant difference in overall stone-free rates between US-guided and FS-guided SWL RR 0.76(95% CI; 0.61-0.95, p=0.02) and in adults RR 0.76(95% CI; 0.60-0.96), but not children groups RR 0.68(95% CI; 0.24-1.88). US-SWL might be favourable due to the radiation-free procedure and real-time presentation. Complication rates were low, and no life-threatening complications were reported. In conclusion, US-guided SWL is more effective than FS-guided SWL for treating renal stones, with a low incidence of complications. Further randomized controlled trials with larger populations are needed to explore the comparison more accurately." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-181", "name": "The comparison of totally ultrasound-guided versus fluoroscopy-guided..." } } ] } Home Browse The comparison of totally ultrasound-guided versus fluoroscopy-guided... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Sihotang RC, Rasyid N, Birowo P et al. The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.12688/f1000research.157981.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Revised The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] Retta Catherina Sihotang https://orcid.org/0000-0001-8076-8586 1 , Nur Rasyid https://orcid.org/0000-0003-4473-755X 1 , Ponco Birowo https://orcid.org/0000-0003-2934-6753 1 , Gerhard Reinaldi Situmorang 1 , Widi Atmoko https://orcid.org/0000-0002-7793-7083 1 Retta Catherina Sihotang https://orcid.org/0000-0001-8076-8586 1 , Nur Rasyid https://orcid.org/0000-0003-4473-755X 1 , [...] Ponco Birowo https://orcid.org/0000-0003-2934-6753 1 , Gerhard Reinaldi Situmorang 1 , Widi Atmoko https://orcid.org/0000-0002-7793-7083 1 PUBLISHED 07 Jul 2025 Author details Author details 1 Department of Urology, Faculty of Medicine , Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia Retta Catherina Sihotang Roles: Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation Nur Rasyid Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Writing – Review & Editing Ponco Birowo Roles: Conceptualization, Supervision, Validation, Writing – Review & Editing Gerhard Reinaldi Situmorang Roles: Data Curation, Funding Acquisition, Investigation, Supervision, Writing – Review & Editing Widi Atmoko Roles: Data Curation, Formal Analysis, Investigation, Methodology, Visualization, Writing – Original Draft Preparation OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Extracorporeal shock wave lithotripsy (SWL) has been a well-known therapy since years ago, especially for renal stones less than 20 mm. This study compared the effectiveness of totally ultrasound-guided (US-guided) and fluoroscopy-guided (FS-guided) SWL in treating renal and ureteral stones. A protocol has been registered in PROSPERO databases for systematic reviews. A systematic literature search was conducted in five online databases (PubMed, ScienceDirect, EMBASE, ProQuest, and Scopus). We included all available articles that compared the effectiveness and safety of US-SWL to FS-SWL. A risk of bias assessment was done using Risk of Bias (Rob) Tools for randomized interventional studies and Risk of bias in non-randomized studies interventions (ROBINS-I) Tools for Non-randomized studies. The primary outcome was the stone-free rate, and the secondary outcome was the complication rate. Subgroup analyses were performed for adult and pediatric groups. A comprehensive literature search identified seven comparative articles that matched the criteria: two randomized trials and six retrospective cohort studies comprising 1,255 patients (609 using US-SWL). The results revealed a significant difference in overall stone-free rates between US-guided and FS-guided SWL RR 0.76(95% CI; 0.61-0.95, p=0.02) and in adults RR 0.76(95% CI; 0.60-0.96), but not children groups RR 0.68(95% CI; 0.24-1.88). US-SWL might be favourable due to the radiation-free procedure and real-time presentation. Complication rates were low, and no life-threatening complications were reported. In conclusion, US-guided SWL is more effective than FS-guided SWL for treating renal stones, with a low incidence of complications. Further randomized controlled trials with larger populations are needed to explore the comparison more accurately. READ ALL READ LESS Keywords Shockwave lithotripsy, ultrasound-guided, fluoroscopy-guided, stone-free rate, complication Corresponding Author(s) Ponco Birowo ( [email protected] ) Close Corresponding author: Ponco Birowo Competing interests: No competing interests were disclosed. Grant information: This study was supported by PUTI Grants 2024 with Grant Number ND-2417/UN2.F1.D1.4/PPM.00.00/2024 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Sihotang RC 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 work is properly cited. How to cite: Sihotang RC, Rasyid N, Birowo P et al. The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.12688/f1000research.157981.2 ) First published: 10 Feb 2025, 14 :181 ( https://doi.org/10.12688/f1000research.157981.1 ) Latest published: 07 Jul 2025, 14 :181 ( https://doi.org/10.12688/f1000research.157981.2 ) Revised Amendments from Version 1 In this revised version, we made some modifications based on reviewers' feedback. We added more detailed baseline characteristics, including age, gender, stone size, location, and density. In the Results, we included descriptive data on energy settings, shock frequency, and number of SWL sessions, as well as specific complications (e.g., hematuria, steinstrasse) when reported. Due to inconsistent reporting across studies, these subgroup findings were presented narratively. The Discussion and Limitations sections were updated accordingly to highlight the implications of heterogeneity and the need for better standardization in future research. In this revised version, we made some modifications based on reviewers' feedback. We added more detailed baseline characteristics, including age, gender, stone size, location, and density. In the Results, we included descriptive data on energy settings, shock frequency, and number of SWL sessions, as well as specific complications (e.g., hematuria, steinstrasse) when reported. Due to inconsistent reporting across studies, these subgroup findings were presented narratively. The Discussion and Limitations sections were updated accordingly to highlight the implications of heterogeneity and the need for better standardization in future research. To read any peer review reports and author responses for this article, follow the "read" links in the Open Peer Review table. READ REVIEWER RESPONSES Introduction Extracorporeal shock wave lithotripsy (SWL) has been a well-known therapy for treating urinary stones since the early 1980s. 1 , 2 The stone disease may affect about 10% of the global population and remains an important cause of morbidity, which provides huge opportunities for healthcare costs and discomfort to patients worldwide. For the treatment of renal or pyelonephritis stones, there is a current trend toward using minimally invasive endoscopic methods, such as ureteroscopy and percutaneous nephrolithotomy. SWL remains one of the leading treatment choices for renal stones less than 20 mm despite this progression. SWL has a low incidence of complications and does not necessitate general anesthesia. 3 – 5 Ultrasonography (US) (B-scan ultrasound) or fluoroscopy (FS) must be used to appropriately visualize the stone to focus the shock waves as precisely as possible for SWL to be successful (X-rays). Radiopaque stones in the kidney calyces, renal pelvis, or ureteropelvic junction (UPJ) are frequently visible on US and FS. Although the energy source and coupling devices have changed little in recent years, advances in SWL technology have led to the ultrasonic (US) localization of stones. Real-time imaging without radiation exposure is a specialty of ultrasound, especially in the visualization of radiolucent stones or in pediatric and pregnant populations. Being also the modality with the best anatomical detail, fluoroscopy is, however, preferentially applied in localizing radiopaque stones, which makes it a standard imaging modality in many centers. The combination of US and FS has improved the success rate of SWL in a few studies. By alternating ultrasound and fluoroscopy, the lithotripter’s energy can be more concentrated on the target stone throughout the entire session, enhancing SWL efficiency. Unfortunately, few studies have examined the effectiveness of totally ultrasound-based and fluoroscopy-based lithotripters. It is difficult to compare the efficacy between different institutions due to variabilities in treatment procedures and operators. 6 Although ultrasound-guided SWL is increasingly adopted due to its reduced radiation exposure, evidence comparing its effectiveness (stone-free rate) and safety (complication rate) with fluoroscopy-guided SWL remains inconclusive. This systematic review and meta-analysis aimed to compare both outcomes in the treatment of renal stones. Methods This study was conducted on the guideline of Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020. The study protocol was registered in the PROSPERO database ( www.crd.york.ac.uk/prospero ) under registration number CRD42023403319. Search strategy A comprehensive literature search was conducted in five international online databases: PubMed ( https://pubmed.ncbi.nlm.nih.gov ), ScienceDirect ( https://www.sciencedirect.com ), EMBASE ( https://www.embase.com ), Proquest ( https://www.proquest.com ), and Scopus ( https://www.scopus.com ) on June 16th, 2024. The keywords used in the search strategy were “ultrasound”, “fluoroscopy”, and “shockwave lithotripsy”. We included all comparative studies, including randomized controlled trials (RCT), prospective non-randomized trials, cohort, and case-control studies comparing the stone-free rate of US-SWL versus the conventional FS-SWL We included all articles that were available in English. Eligibility criteria The included studies’ inclusion criteria were as follows: 1) patients with renal stones; 2) studies comparing totally US-SWL to FS-SWL; 3) reporting stone-free rate and complication rate, if available; 4) Articles available in English. The exclusion criteria were: 1) non-comparative studies, 2) meta-analysis studies, 3) review studies, and 4) studies using the combination of US-SWL and FS-SWL. Quality assessment Two reviewers (RCS and NR) screened the available studies independently based on the title and abstracts. The retrieved full texts were reviewed independently to confirm the eligibility criteria and continue to extract data. Each study will be extracted into a table consisting of authors, study designs, subjects, group comparison, location and size of renal stones, stone-free rate, outcome definition, and complication rate. Included articles will be assessed using Risk of Bias (Rob) Tools in Review Manager (RevMan) 5.4 software ( https://revman.cochrane.org ) for randomized interventional studies and Risk of bias in non-randomized studies interventions (ROBINS-I) Tools for Non-randomized studies. The quality assessment was performed independently by four contributors (GR, NR, PB, WD). Outcomes The study’s primary outcome was stone-free rate, while the secondary outcome was a complication rate. We also performed subgroup analysis dividing the outcomes in two subgroups, which are adults and children subgroups. We also explored heterogeneity sources by assessing subgroup differences based on stone location (e.g., upper, mid, lower calyx), stone size, and number of SWL sessions when data were available. However, due to incomplete data and heterogeneity in outcome definitions across studies, these subgroup analyses were performed descriptively rather than quantitatively. Complications, when reported, were extracted as overall complication events. Due to inconsistent reporting, further categorization (e.g., hematuria, infection, steinstrasse) could not be systematically analyzed. Statistical analysis The pooled effect size of dichotomous outcomes was summarized using the risk ratio (RR). The Chi-square test and I2 statistic were used to gauge the degree of study heterogeneity; I2 values below 50% are considered homogenous. In the absence of low heterogeneity, a random effect model was applied. The statistical analyses were performed using Review Manager 5.4. Metanalysis was performed using a forest plot for stone-free and complication-rate outcomes. Results We retrieved 272 hits on the five online databases ( Table 1 ). A total of 121 duplicate articles and 100 irrelevant studies were excluded from the analysis. After screening and selecting the articles, we included eight articles in this systematic review and quantitative analysis ( Figure 1 ). The articles included two randomized trials and six retrospective cohort studies. 7 – 14 The characteristics of the included studies are presented in Table 2 . We extracted any available data from the studies, including subjects’ characteristics, stone size, stone density (in Hounsfield Unite - HU), stone location, SFR definition, SWL technique, and the outcomes. The quality of the study showed a low to moderate risk of bias based on the Rob Tools and ROBINS-I Tools ( Table 3 , Figure 2 ). The oldest study was conducted in 2010, and the most recent study was conducted in 2023. The sample size varied from 40 to 495 patients and was divided into US-SWL and FS-SWL groups. Most patients presented renal stones from the imaging examination, however, a study by Motolova et al. 10 included patients with proximal and distal ureters. Given the operator-dependent nature of ultrasound, all ultrasound-guided SWL procedures in the included studies were performed by urologists. We performed a quantitative analysis of seven studies, consisting of three of the children population and four of the adult population. Funnel plot analysis and Egger’s test could not be performed because the included studies were less than 10. Table 1. Literature Search Strategies and Results. Database Search Query Result Access Date PubMed (Ultrasound shockwave lithotripsy [Title/Abstract]) AND (fluoroscopy shockwave lithotripsy [Title/Abstract]) 38 16 June 2024 ScienceDirect Ultrasound Shockwave Lithotripsy [Title, abstract, keyword] 35 16 June 2024 EMBASE (‘ultrasound shockwave lithotripsy’ OR ((‘ultrasound’/exp OR ultrasound) AND (‘shockwave’/exp OR shockwave) AND (‘lithotripsy’/exp OR lithotripsy))) AND (‘fluoroscopy guided’ OR ((‘fluoroscopy’/exp OR fluoroscopy) AND guided)) 13 16 June 2024 ProQuest ultrasound AND fluoroscopy shockwave lithotripsy AND renal stone [Title, abstract, keyword] 167 16 June 2024 Scopus ultrasound AND fluoroscopy shockwave lithotripsy AND renal stone 19 16 June 2024 Figure 1. PRISMA flow diagram of study selection. Table 2. Table of summary for study findings. Authors Study design Subjects Age of participants (mean ± SD) Participants’ sex Comparison Stone size (mean ± SD) Stone size (classification) Stone location Stone density Stone-free rate Abdel Kader, 2023 7 Prospective randomized study Children aged 2–16 years who presented with radiopaque renal pelvic stones <20 mm. Group US : 9.21 ± 3.93 years Group FS : 9.34 ± 4.15 years Group US (male/female) : 23/27 Group FS (male/female) : 26/24 Group US : 50 patients Group FS : 50 patients Group US : 14.16 ± 2.05 mm Group FS : 13.88 ± 1.75 mm No data No data Group US : 544.64 ± 218.11 Group FS : 519 ± 207.73 After 1 month follow up ( p = 0.749): Group US : 42/50 (84%) Group FS : 35/50 (90%) Arunagiri, 2010 8 Prospective non randomized study (Dissertation) Adults patients with Renal stones 5 mm – 2 cm in diameter in the upper, middle calyx or Renal Pelvis and ≤1 cm in the lower calyx. Group US : 34.74 ± 9.8 Group FS : 31.32 ± 6.8 Group US (male/female): 26/24 Group FS (male/female): 29/21 Group US : 50 patients Group FS : 50 patients Group US : 12.24 ± 4.25 mm Group FS : 14.04 ± 3.3 mm < 5 mm : 4 6-10 mm : 27 11-20 mm: 69 Pelvis: 60 Upper and Middle calyx: 20 Lower calyx: 20 No data After 2 weeks: Group US : overall 35/50 (70%) <5 mm 4/4 (100%) 6-10 mm 12/17 (70.5%) 11-20 mm 19/29 (65.5%) Group FS : overall 32/50 (64%) 6-10 mm 6/10 (60%) 11-20 mm 26/40 (65%) Goren, 2017 9 Retrospective study Children with renal stones treated between January 2009 and August 2015 were retrospectively reviewed. Group US : 3 ± 1.7 years Group FS : 2.9 ± 1.5 years Male/female: 28/16 Group US : 31 patients Group FS : 20 patients Group US : 16 ± 2.91 mm Group FS : 16.4 ± 3 mm No data Upper calyx: 10 Mid calyx: 14 Lower calyx: 13 Pelvis: 14 No data Initial SFR: Group US : 25/31 (80,6%) Group FS : 5/20 (25%) 3 months follow up SFR (p = 0.008) : Group US : 29/31 (93,5%) Group FS : 12/20 (60%) Motolova, 2021 10 Retrospective study Adult population as the first intervention to solve X-ray-contrast nephrolithiasis, proximal and distal ureterolithiasis of size 6–13 mm. No data No data Group US : 120 patients Group FS : 140 patients Group US : 7.8 ± 1.8 mm Group FS : 8.0 ± 1.9 mm No data Upper calyx: 40 Mid calyx: 86 Lower calyx : 40 Pelvis : 38 Group US : 1022.9 ± 168.1 Group FS : 1006.3 ± 163.0 Group US : 108/120 (90%) Group FS: 126/140 (90%) Ozkaya, 2019 11 Retrospective study Children under 16 years of age who were treated with SWL using ultrasonic and fluoroscopic focusing were included in the study. Group US: 8.6 Group FS: 7.1 Group US (male/female): 139/94 Group FS (male/female): 154/108 Group US : 233 patients Group FS : 262 patients Group US : 8.9 ± 3.66 mm Group FS : 8.73 ± 3.98 mm 5-9 mm: 266 10-15 mm : 224 >15 mm : 15 Upper calyx: 99 Mid calyx, pelvis: 325 Lower calyx: 70 No data Group US : 215/233 (92.3%) Group FS: 237/262 (90.5%) Periasamy, 2024 12 Retrospective Study Adults age 20-60 years old were retrospectively reviewed. No data No data Group US: 20 patients Group FS: 20 patients Group US: 9 mm Group FS: 8.5 mm 0-0.9 mm: 17 0.9-1.5 mm: 23 Upper calyx: 13 Mid calyx: 15 Lower calyx: 7 Pelvis: 5 No data Group US: 17/20 (85%) Group FS: 16/20 (80%) Smith, 2015 13 Retrospective study Adults patients receiving initial treatment for renal calculi in our unit on the same lithotripsy machine from 2012 to 2013. Group US: 59 years Group FS: 58 years No data Group US: 48 patients Group FS : 47 patients Group US: 8.5 mm Group FS: 9.3 mm 7 mm: 57 Upper calyx : 9 Mid calyx: 18 Lower calyx: 58 Pelvis: 10 No data Group US: 29/48 (60%) 7 mm 11/27 (40.7%) Group FS : 21/47 (45%) 7 mm 11/30 (36.6%) Van Besien, 2017 14 Randomized Prospective Patients with radiopaque UUTS were eligible to be enrolled in this prospective single-center study. No data No data Group US : 57 patients Group FS : 57 patients Group US : 9 ± 3 mm Group FS : 8.5 ± 3 mm 0–4 mm: 10 5–9 mm: 60 10–20 mm: 44 Upper calyx: 26 Mid calyx: 31 Lower calyx: 44 Pelvis: 13 Group US : 665 ± 160 Group FS : 740 ± 223 Group US : 34/57 (52%) Group FS : 24/57 (42%) Table 3. Risk of bias in non-randomized studies interventions (ROBINS-I) Tools for Non randomized studies. Study Bias due to confounding Bias in selection of participants into the study Bias in classification of interventions Bias due to deviations from intended interventions Bias due to missing data Bias in measurement of outcomes Bias in selection of the reported result Overall bias Arunagiri 2011 Moderate Moderate Low Low Low Moderate Moderate Moderate Goren 2017 Low Moderate Low Low Low Low Low Moderate Motolova 2021 Low Moderate Low Low Low Moderate Low Moderate Ozkaya 2019 Low Low Low Low Low Low Low Low Periasamy 2024 Moderate Low Low Low Low Low Low Low Smith 2016 Moderate Moderate Low Low Low Moderate Low Moderate Figure 2. Risk of Bias (Rob) Tool for randomized interventional studies. Stone free rate The stone-free rate is an absence of residual stones in a follow-up period after the shockwave lithotripsy procedure. The stone-free rate definition varied across studies, which might be a confounding factor in the result. Eight studies comprised 1,255 patients; 609 (48,5%) underwent ultrasound shockwave lithotripsy. The stone-free rate in US-SWL varied from 52-93%, while in FL-SWL varied from 40-90.5%. In our metaregression analysis, there were significant differences observed in the case SFR between ultrasound-guided and fluoroscopy-guided RR 0.76(95% CI; 0.61-0.95, p=0.02) ( Figure 3 ). We also divided the patients into adult RR and children groups. There were significant differences within the adult RR 0.76(95% CI; 0.60-0.96) but not significant in children groups RR 0.68(95% CI; 0.24-1.88), respectively. Among the included studies, three studies; Arunagiri et al., Van Besien et al., Ozkaya et al., provided subgroup results based on stone location. These suggest that SFR tended to be lower for stones in the lower calyx compared to other sites. Similarly, other studies Periasamy et al. and Smith et al., reported higher SFR in stones <10 mm. However, variations in definitions and incomplete subgroup data limited formal comparison across studies. Figure 3. Forrest plot of stone free rate. Complication rate We included all studies that prove complication rate data. Five studies reported complication rates between the two groups. The reported complications were pain, transient hematuria, fever, urinary tract infection, steinstrasse, and further interventions. However, we exclude one article 12 due to outlier values. Of the four studies, three studies reported the incidence in the Clavien-Dindo classification system (grade I - V). One study only reported the complication by the need for further interventions. None of the studies reported complications of Grade IV or V (threatening complications). In terms of specific complication types, only two studies (Arunagiri and Goren et al.) provided detailed breakdowns. Arunagiri et al. presented incidence rates for hematuria, fever, UTI, and steinstrasse, while Goren et al. reported low-grade infections and fever managed conservatively. Due to inconsistent reporting across studies, a subgroup meta-analysis by complication subtype could not be conducted. In the pooled analysis, the overall complication rate between the two groups did not differ by RR 0.91(95% CI; 0.35-2.39) ( Figure 4 ). The management of complications is mainly pharmacological, using anti-inflammatory drugs and antibiotics, and some need further interventions such as additional SWL sessions, secondary ureteroscopy, or percutaneous nephrolithotomy. A visual presentation of the funnel plot showed no potential sources of small study effects for complication rate ( Figure 4 ). Figure 4. Forrest plot of complication rate. Discussion US-SWL and FS-SWL employ focused shockwaves to break kidney stones. However, the two techniques differ in their imaging modalities for localizing the stone during treatment. 15 – 17 Ultrasound is radiation-free, reducing the risk of radiation-induced complications for patients and healthcare professionals. 18 Additionally, ultrasound is a real-time imaging modality, allowing for continuous monitoring and adjustment during the procedure and providing an accurate assessment of stone fragmentation and size. Focusing the shockwaves on the stone can be accomplished to achieve optimal fragmentation. 9 , 19 On the other hand, FS-SWL relies on fluoroscopy for stone localization. 20 Despite the exposure to ionizing radiation, fluoroscopy can better visualize certain stone types, particularly those with high radiopacity. This can lead to improved treatment outcomes in specific cases. 21 This is the first meta-analysis comparing the effectiveness (SFR) and safety (complication rates) of US-SWL and FS-SWL. For the stone-free rate outcome, we divided the analysis based on the population, adults and children. In our study, we found that US-SWL is more effective than FS-SWL in terms of stone-free rate after the procedure. The stone-free rate ranged from 52 to 93% for the US-SWL group and 40 to 90.5% for the FS-SWL groups. Studies from Goren et al., 10 Arunagiri et al., 8 Smith et al., 13 and Van Beisen et al. 14 showed a higher stone-free rate in the US-SWL group than the FS-SWL group. However, in the children population analysis, the stone-free rate does not differ. This might be due to the cooperativeness during the procedure. Similar results were also demonstrated in the complication rate. Of the seven studies, only four studies provide the measurement of complication rates. The complication was relatively low, ranging from 0,1-32%. A study by Goren et al. 10 reported significantly lower complications in the US-SWL group, while other studies reported no significant difference. None of the complications was life-threatening. There were no significant differences between both groups. The reported complications were pain, lower urinary tract symptoms, transient hematuria, fever, urinary tract infection, steinstrasse, and further interventions. The management of the complications was mainly conservative with supported medication (anti-inflammatory, analgesic, antibiotics). Subjects with Clavien Dindo Grade 3 required further intervention for ureteric stenting or endourology procedures. Generally, numerous factors can impact the ultimate stone-free rate (SFR) outcome of extracorporeal shock wave lithotripsy (SWL), regardless of the guidance method used. The factors were divided into stone characteristics (size, composition, and location), patient characteristics (age, BMI, anatomical factors), and technique-related factors (shockwave energy and frequency, number of treatment sessions, and operator experience). Stone size, density, and locations affect the outcome of SWL. The results of SWL for renal stones up to 10 mm in diameter are satisfactory regardless of their location in the kidney. 22 – 24 Stone density obtained from CT KUB was demonstrated as a predictor for the success rate of SWL. 25 , 26 Some stones (e.g., calcium oxalate monohydrate and cystine) are harder and more resistant to fragmentation, leading to a lower SFR. Gupta et al. 27 found that SWL outcomes were best when the mean stone density was 750 HU. In a separate prospective study involving 50 patients with urinary stones, the author determined that a stone density threshold of 970 HU is a precise and sensitive predictor of SWL outcome. 28 A study by El-Nahas et al. 29 discovered that stone density greater than 1000 HU significantly predicts SWL failure. El-Assmy et al. 30 concluded that an HU value of 600 HU and a stone length of 1.2 cm were significant independent predictors of SWL efficacy when treating urinary stones in children. Additionally, Stones located in the lower pole of the kidney or lower ureter tend to have a lower SFR due to challenges in clearing the fragments. 16 The patient’s age, BMI, and anatomical abnormalities may also alter the SFR. Older patients may have a lower SR due to age-related factors, such as reduced renal function or altered anatomy. 19 A higher BMI can decrease the effectiveness of SWL by increasing the distance between the shockwave source and the stone. Waqas et al. found that patients with BMI 30 kg/m2. 31 Anatomy abnormalities, such as patients with skeletal anomalies, renal malformations, or strictures in the urinary tract, may have a lower SFR due to difficulty reaching the stones and unfavorable fragments passage. 21 The SF can be affected by the frequency and energy of the shockwaves, with higher energy and lower frequency generally yield better results. Among the eight included studies, only Periasamy et al. reported detailed procedural parameters, including shock wave frequency (90–110 shocks/min), total number of shocks (3000 per session), and mean energy levels (64 J in the US group and 68 J in the FS group). Van Besien et al. used a standardized ramping protocol with a fixed frequency of 1 Hz, 2500 shocks per session, and a reported mean energy of 49–53 J. Goren et al. initiated treatment at 9.5 kV with stepwise escalation. A systematic review and meta-analysis by Kang et al. 32 showed that low-frequency success rates (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. Multiple sessions may be required to achieve a higher SFR. Data on the number of SWL sessions were available in Periasamy et al. (mean 2.6 sessions in the US group vs. 2.7 in the FS group) and Motolová et al. (mean 1.3 sessions in the US group vs. 1.5 in the FS group). However, the remaining studies did not report these procedural parameters, limiting our ability to assess their contribution to heterogeneity. According to Goren et al., 10 the median number of SWL sessions in the US-guided group was considerably smaller than in the FL-guided group. In a cohort study by Grabsky et al. 33 in the pediatric population, the SFR after only 1- session of SWL was 88.0% and increased to 91.7% after several sessions. Several other studies also reported the high SF in SWL achieved after several treatment sessions. 34 , 35 SWL treatment’s effectiveness also relies upon the operator’s level of expertise. The requirement of pinpoint imaging localization of the stone and proper acoustic coupling to the flank region of the patient is essential because these factors directly influence the quality of the outcome. 14 In children, the US-SWL faces technical challenges. The probe used on the shockwave lithotripter was commonly convex and adult-sized. For focusing stones on infants and children, probes sized for adults can be challenging to use. In patients with a small abdominal volume, pressing the abdomen with an adult-sized probe may shift the kidney toward adjacent organs, resulting in the coaction of surrounding tissues by the shockwaves. 10 Some studies reported lower stone-free rates in lower pole stones and larger calculi, for example, Arunagiri et al. and Smith et al., but these findings were not consistently observed, as most other studies did not report outcomes by stone size or location. Similarly, only a few studies, for example, Arunagiri and Goren, described specific complications such as hematuria or steinstrasse, while most reported only overall complication rates. These patterns should be interpreted with caution, and future studies should provide more detailed and standardized reporting for better subgroup comparisons. Limitation The current study only assessed stone-free and complication rates as outcomes due to limited and dissimilar data of other secondary outcomes in the studies. Several studies used varying definitions for stone-free rate and complications, limiting comparability. Due to incomplete or incompatible data, we were unable to perform subgroup meta-analyses for potentially important clinical variables such as stone location, size, density, number of sessions, and energy/frequency settings. Additionally, complications were often reported as overall rates without specification or standardized classification, which restricted further analysis of individual adverse events. The majority of the included studies were retrospective and had relatively small sample sizes, increasing the risk of selection and publication bias. These limitations reduce the certainty of the findings and warrant cautious interpretation when applying them to clinical decision-making. Conclusions The current study found significant differences in stone-free rates of renal stone between the US-SWL and FS-SWL in the adult group but not in the pediatric groups. There is no difference in terms of complication rates between the two imaging modalities. None of the studies reported any life-threatening complications. The US-SWL is more effective than FS-SWL in treating renal and ureteral stones, with a low incidence of complications, especially in the adult population. Subgroup comparisons based on stone characteristics or complication types could not be conclusively drawn due to inconsistent data reporting across studies, highlighting the need for future studies to address these specific variables. Further randomized controlled trials with larger populations are needed to explore the comparison more accurately. We also recommend evaluating the effectiveness of both modalities in ureteral stones in future studies. Ethics and consent No ethics and consent were required. Data availability No data are associated with this article. Extended data Figshare: “Study Characteristics from Included Studies”, https://doi.org/10.6084/m9.figshare.28263743.v1 . 36 This project contains following extended data: • Supplementary Data_Study Characteristics.docx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Reporting guidelines Figshare: PRISMA checklist for “The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis”, https://doi.org/10.6084/m9.figshare.27231654.v1 . 37 Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements Thanks to Rinaldo Indra Rachman for initiating the idea of this systematic review. References 1. Manzoor H, Saikali SW: Renal extracorporeal lithrotripsy. Statpearls. 2022. Reference Source 2. Chaussy C, Brendel W, Schmiedt E: Extracorporeally induced destruction of kidney stones by shock waves. Lancet (London, England). 1980; 2 (8207): 1265–1268. PubMed Abstract | Publisher Full Text 3. Shafi H, Moazzami B, Pourghasem M, et al. : An overview of treatment options for urinary stones. Caspian J. Intern. Med. 2016; 7 (1): 1–6. PubMed Abstract 4. Ruggera L, Beltrami P, Ballario R, et al. : Impact of anatomical pielocaliceal topography in the treatment of renal lower calyces stones with extracorporeal shock wave lithotripsy. Int. J. Urol. 2005; 12 : 525–532. PubMed Abstract | Publisher Full Text 5. Ghoneim IA, Ziada AM, Elkatib SE: Predictive factors of lower calyceal stone clearance after extracorporeal shockwave lithotripsy (ESWL): A focus on the infundibulopelvic anatomy. Eur. Urol. 2005; 48 : 296–302. PubMed Abstract | Publisher Full Text 6. Chang T-H, Lin W-R, Tsai W-K, et al. : Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones. BMC Urol. 2020; 20 (1): 183. PubMed Abstract | Publisher Full Text | Free Full Text 7. Abdel-Kader MS, Fathy A, Moubarek M, et al. : Which is better, fluoroscopic-guided or ultrasonic-guided shock wave lithotripsy for pediatric renal stones? prospective randomized comparative study. World. J. Urol. 2023; 1 (1): 1–6. 8. Arunagiri A: Comparative study of efficacy of localization and fragmentation of renal stone by USG and fluoroscopy guided ESWL. Chennai: Kilpauk Medical College; 2010. [master’s thesis]. 9. Goren MR, Goren V, Ozer C: Ultrasound-guided shockwave lithotripsy reduces radiation exposure and has better outcomes for pediatric cystine stones. Urol. Int. 2017; 98 (4): 429–435. PubMed Abstract | Publisher Full Text 10. Motolová M, Král M: Ultrasound versus fluoroscopic localisation during extracorporeal shockwave lithotripsy. Ces Urol. 2021; 25 (2): 112–9. Czech. 11. Ozkaya F: Comparison of the results of shock wave lithotripsy with ultrasonic and fluoroscopic focus in pediatric age group; fluoroscopic focusing how much is needed? Ann. Med. Res. 2021; 26 (11): 2502–2506. Publisher Full Text 12. Periasamy P, Narashimman J, Maruthamuthu R, et al. : The comparison of outcomes between USG guided ESWL Vs Fluoroscopy guided ESWL – Our institutional experience. Asian J. Med. Sci. 2024; 15 (2): 227–230. Publisher Full Text 13. Smith HE, Bryant DA, KooNg J, et al. : Extracorporeal shockwave lithotripsy without radiation: ultrasound localization is as effective as fluoroscopy. Urol. Ann. 2016; 8 (4): 454–457. PubMed Abstract | Publisher Full Text | Free Full Text 14. Van Besien J, Uvin P, Hermie I, et al. : Ultrasonography is not inferior to fluoroscopy to guide extracorporeal shock waves during treatment of renal and upper ureteric calculi: a randomized prospective study. Biomed. Res. Int. 2017; 2017 : 7802672. 15. Sheir K, Madbouly K, Elsobsky E: Prospective randomized comparative study of the effectiveness and safety of electrohydraulic and electromagnetic extracorporeal shockwave lithotriptors. J. Urol. 2003; 170 : 389–392. PubMed Abstract | Publisher Full Text 16. Türk C, Skolarikos A, Neisius A, et al. : EAU guidelines on urolithiasis. European Association of Urology; 2023. 17. Connors BA, Evan AP, Willis LR, et al. : The effect of discharge voltage on renal injury and impairment caused by lithotripsy in the pig. J. Am. Soc. Nephrol. 2000; 11 (2): 310–318. PubMed Abstract | Publisher Full Text 18. Smith-Bindman R, Moghadassi M, Wilson N, et al. : Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch. Intern. Med. 2009; 169 (22): 2078–2086. PubMed Abstract | Publisher Full Text | Free Full Text 19. Chaussy C, Schmiedt E, Jocham D, et al. : First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J. Urol. 1982; 127 (3): 417–420. PubMed Abstract | Publisher Full Text 20. Lingeman JE, McAteer JA, Gnessin E, et al. : Shock wave lithotripsy: advances in technology and technique. Nat. Rev. Urol. 2009; 6 (12): 660–670. PubMed Abstract | Publisher Full Text | Free Full Text 21. Zhu W, Liu Y, Liu L, et al. : Ultrasound versus fluoroscopy-guided percutaneous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis. 2018; 46 (5): 431–443. 22. Lingeman JE, Siegel YI, Steele B, et al. : Management of lower pole nephrolithiasis: a critical analysis. J. Urol. 1994; 151 : 663–667. PubMed Abstract | Publisher Full Text 23. Ilker Y, Tarcan T, Akdas A: When should one perform shock wave lithotripsy for lower caliceal stones? J. Endourol. 1995; 9 : 439–441. PubMed Abstract | Publisher Full Text 24. Chen RN, Streem SB: Extracorporeal shock wave lithotripsy for lower pole calculi: long-term radiographic and clinical outcome. J. Urol. 1996; 156 : 1572–1575. PubMed Abstract | Publisher Full Text 25. Abdelaziz H, Elabiad Y, Aderrouj I, et al. : The usefulness of stone density and patient stoutness in predicting extracorporeal shock wave efficiency: results in a North African ethnic group. Can. Urol. Assoc. J. 2014; 8 (7–8): E567–E569. PubMed Abstract | Publisher Full Text 26. Magnuson WJ, Tomera KM, Lance RS: Hounsfield unit density accurately predicts ESWL success. Alaska Med. 2005; 47 (2): 6–9. PubMed Abstract 27. Gupta NP, Ansari MS, Kesarvani P, et al. : Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int. 2005; 95 (9): 1285–1288. PubMed Abstract | Publisher Full Text 28. Murshidi MS: Simple radiological indicators for staghorn calculi response to ESWL. Int. Urol. Nephrol. 2006; 38 (1): 69–73. PubMed Abstract | Publisher Full Text 29. El-Nahas AR, El-Assmy AM, Mansour O, et al. : A prospective multivariate analysis of factors predicting stone disintegration by extracorporeal shock wave lithotripsy: the value of high-resolution noncontrast computed tomography. Eur. Urol. 2007; 51 (6): 1688–1693. discussion 93-4. PubMed Abstract | Publisher Full Text 30. El-Assmy A, El-Nahas AR, Abou-El-Ghar ME, et al. : Kidney stone size and Hounsfield units predict successful shockwave lithotripsy in children. Urology. 2013; 81 (4): 880–884. PubMed Abstract | Publisher Full Text 31. Waqas M, Ayaz Khan M, Waqas Iqbal M, et al. : Non-contrast computed tomography scan based parameters of ureteric stones affecting the outcome of extracorporeal shock wave lithotripsy. Cureus. 2017; 9 (5): e1227. PubMed Abstract | Publisher Full Text 32. Kang DH, Cho KS, Ham WS, et al. : Comparison of high, intermediate, and low frequency shock wave lithotripsy for urinary tract stone disease: Systematic Review and network meta-analysis. PLoS One. 2016; 11 (7): e0158661. PubMed Abstract | Publisher Full Text | Free Full Text 33. Grabsky A, Tsaturyan A, Musheghyan L, et al. : Effectiveness of ultrasound- guided shockwave lithotripsy and predictors of its success rate in pediatric population: a report from a national reference center. J. Pediatr. Urol. 2021; 17 (1): 78.e1–78.e7. PubMed Abstract | Publisher Full Text 34. D’Addessi A, Bongiovanni L, Sasso F, et al. : Extracorporeal shockwave lithotripsy in pediatrics. J. Endourol. 2008; 22 (1): 1–12. Publisher Full Text 35. He L, Sun X, Lu J, et al. : Comparison of efficacy and safety of shockwave lithotripsy for upper urinary tract stones of different locations in children: a study of 311 cases. World. J. Urol. 2011; 29 (6): 713–717. Publisher Full Text 36. Sihotang RC, Rasyid N, Birowo P, et al. : PRISMA CHECKLIST_The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis. [Dataset]. figshare. 2024. Publisher Full Text 37. Sihotang RC, Birowo P, Rasyid N, et al. : Study Characteristics from Included Studies. Dataset. figshare. 2025. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Feb 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of Urology, Faculty of Medicine , Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia Retta Catherina Sihotang Roles: Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation Nur Rasyid Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Writing – Review & Editing Ponco Birowo Roles: Conceptualization, Supervision, Validation, Writing – Review & Editing Gerhard Reinaldi Situmorang Roles: Data Curation, Funding Acquisition, Investigation, Supervision, Writing – Review & Editing Widi Atmoko Roles: Data Curation, Formal Analysis, Investigation, Methodology, Visualization, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information This study was supported by PUTI Grants 2024 with Grant Number ND-2417/UN2.F1.D1.4/PPM.00.00/2024 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 07 Jul 2025, 14:181 https://doi.org/10.12688/f1000research.157981.2 version 1 Published: 10 Feb 2025, 14:181 https://doi.org/10.12688/f1000research.157981.1 Copyright © 2025 Sihotang RC 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 work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Sihotang RC, Rasyid N, Birowo P et al. The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.12688/f1000research.157981.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 07 Jul 2025 Revised Views 0 Cite How to cite this report: Huang YR. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r416537 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-416537 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Oct 2025 Yu-Ren Huang , Case Western Reserve University, Cleveland, Ohio, USA Approved VIEWS 0 https://doi.org/10.5256/f1000research.184222.r416537 Overall, I find the manuscript is well written and suitable for indexing. Minor Revisions: In some of the studies listed, the location and size of the stones were missing per table 2 shown. ... Continue reading READ ALL Overall, I find the manuscript is well written and suitable for indexing. Minor Revisions: In some of the studies listed, the location and size of the stones were missing per table 2 shown. The author indicated the limitation of the studies, however, if the subgroups of stones can be analyzed, it would be helpful to address the heterogeneity and bias. The baseline characteristics of the included studies should be described in more detail. It would be valuable to include variables such as the hospital setting, patient ethnicity, geographical background and the stone related history to provide better context of the participants. The manuscript currently reports complication rates without clearly differentiating whether these complications are directly attributable to the extracorporeal shock wave lithotripsy procedure or are sequelae related to the underlying stone disease (e.g., symptoms from stone passage or pre-existing infections). Consider including the specific timeframe for included studies (e.g., from year X to 2024) for completeness. Are the rationale for, and objectives of, the Systematic Review clearly stated? Partly Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Urology, Genetics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Huang YR. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r416537 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-416537 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Yan P. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r413988 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-413988 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 08 Oct 2025 Phyllis Yan , University of Michigan, Ann Arbor, Michigan, USA Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.184222.r413988 This is an interesting review that highlights the need for additional research to compare the use of ultrasound-guided and fluoroscopy-guided shock wave lithotripsy in treating renal and ureteral stones. I have reviewed this from a statistical perspective and identified some ... Continue reading READ ALL This is an interesting review that highlights the need for additional research to compare the use of ultrasound-guided and fluoroscopy-guided shock wave lithotripsy in treating renal and ureteral stones. I have reviewed this from a statistical perspective and identified some areas for clarity and improvement. Many of my comments are based on the latest guidelines for meta-analyses and systematic reviews in urology [1]. The comments are as follows: Major comments: Random effects analysis requires an estimate of the between study variance, and this estimate is unreliable when the number of studies is small [1]. Since the number of included studies was less than ten, the authors should use a more conservative approach such as the Hartung-Knapp-Sidik-Jonkman method to calculate the confidence intervals. As other reviewers have noted - for the analyses related to stone free rates in children and complication rates, there seems to be a large amount of heterogeneity and indeed different direction of effects between the studies, although most studies do not have significant results. Because of this, I think it makes more sense to just describe the potential sources of heterogeneity between the studies rather than to pool the results of the studies, see guidelines 4.1 and 4.2 [1]. The risk of bias for each study was assessed, but not incorporated into the findings or conclusions, see guideline 3.3 [1]. Perhaps the authors can assess the quality of evidence of the pooled results using the GRADE approach [2]. For the stone free rate analyses, I am not sure why the authors chose to present the risk ratio of a non-event, rather than the risk ratio of a stone free event. I think it would be more intuitive for the authors to present the stone-free risk ratios rather than the non-event risk ratios, and state that the overall stone free rate for US-guided SWL was higher than the stone free rate for FS-guided SWL. Either way, the authors need to clearly interpret the risk ratios throughout the text, instead of only stating that they reveal a significant or non-significant difference in overall stone-free rates between US-guided and FS-guided SWL. The authors should describe what event is being modeled, and what is the direction of the effect of US-guided SWL compared to FS-guided SWL. Minor comments: In the abstract the authors state that “A comprehensive literature search identified seven comparative articles that matched the criteria”, should this be eight? Similarly, in the results section, the authors state “We performed a quantitative analysis of seven studies, consisting of three of the children population and four of the adult population”. However, in the forest plot there seem to be five studies included for the adult population. Quality assessment: How were disagreements in data abstraction and risk of bias assessment handled? PRISMA figure: For the statements “Records identified from*”, and “Records excluded**”, what are the asterisks referring to? Statistical analysis: The statistical analysis section needs to be expanded. All the analyses performed in the study should be described here, including any subgroup analyses, and the meta-regression mentioned in the “Stone free rate” section. The authors should also state what covariates were included in the meta-regression. Statistical analysis: The authors should state the estimation method(s) used for the random effects models. Statistical analysis: The authors should report the tau 2 statistic rather than the I 2 statistic to assess heterogeneity, see guideline 4.3 [1]. Statistical analysis: The authors state that “Metanalysis was performed using a forest plot”. Metanalysis should be changed to “Meta-analysis”, and a forest plot is used to display the results from a meta-analysis, not perform the meta-analysis. Results: The abbreviation SFR should be introduced as “stone free rate (SFR)”. Stone free rate: The authors should elaborate on how the stone-free rate definition varied across studies or cite their supplementary data. Complication rate: The authors should elaborate on why they excluded one study due to outlier values. Which variable had outlier values? Complication rate: I do not see the visual presentation of the funnel plot, and the referenced figure 4 is the forest plot of the complication rate. Also, why not present a visual funnel plot for the stone free rate outcome, if there is a funnel plot for the complication rate outcome? Figures 3 and 4: The labels should say “Forest” rather than “Forrest”. Figures 3 and 4: It would be helpful to have the number of total events for US and FS shown in the “Subtotal (95% CI)” row, rather than the row below. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Partly Is the statistical analysis and its interpretation appropriate? Partly Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable References 1. Vickers A, Assel M, Dunn R, MacLennan G, et al.: Guidelines for meta‐analyses and systematic reviews in urology. BJU International . 2025. Publisher Full Text 2. Guyatt G, Oxman A, Vist G, Kunz R, et al.: GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ . 2008; 336 (7650): 924-926 Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Statistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Yan P. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r413988 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-413988 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 10 Feb 2025 Views 0 Cite How to cite this report: Yogiswara N. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r377157 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-377157 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 14 Apr 2025 Niwanda Yogiswara , Airlangga University, Surabaya, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.173510.r377157 The manuscript is generally well-written, with an appropriate length and adequate language use. The methodology is acceptable, and it is commendable that the authors have registered their review protocol in PROSPERO. Overall, I find the manuscript suitable ... Continue reading READ ALL The manuscript is generally well-written, with an appropriate length and adequate language use. The methodology is acceptable, and it is commendable that the authors have registered their review protocol in PROSPERO. Overall, I find the manuscript suitable for acceptance. However, a few minor revisions are necessary to enhance manuscript clarity. Minor Revisions: The baseline characteristics of the included studies should be described in more detail. It would be valuable to include variables such as the mean age of participants, gender distribution, hospital setting, and patient ethnicity or geographical background to provide better context of the participants. Given the operator-dependent nature of ultrasound, the reviewer suggests the authors specify who performed the ultrasound-guided SWL in the included studies — for instance, whether it was a urologist, a radiologist, or a trained nurse. There appears to be notable heterogeneity in the outcomes related to SFR and complication rates. The authors might consider exploring additional sources of this heterogeneity through subgroup analyses beyond age group — for example, by stratifying according to stone location (e.g., upper pole, renal pelvis), the number of sessions, or variations in energy and frequency settings used during shockwave lithotripsy. In terms of complications, it is unclear whether the analysis refers to overall complications or specific categories. If feasible, a subgroup analysis for individual complications (e.g., hematuria, steinstrasse) would provide valuable insights. If such analysis cannot be performed, the authors should consider addressing this as a limitation. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Urology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Yogiswara N. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r377157 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-377157 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Ismail MB. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r369552 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-369552 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 02 Apr 2025 Mohammed Bassil Ismail , University of Baghdad, Baghdad, Baghdad Governorate, Iraq Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.173510.r369552 There is substantial heterogeneity in stone-free rates among adults and complication rates, which the authors did not evaluate. • Publication bias was not assessed, specifically using a funnel plot and Egger’s test. • The authors did not provide ... Continue reading READ ALL There is substantial heterogeneity in stone-free rates among adults and complication rates, which the authors did not evaluate. • Publication bias was not assessed, specifically using a funnel plot and Egger’s test. • The authors did not provide key details on stone characteristics, including location and Hounsfield units (HFU), as well as intervention settings of the included studies. • I suggest conducting subgroup analyses by stone size and other relevant variables to explore potential sources of heterogeneity. • Due to these methodological limitations, rejection is advised. Are the rationale for, and objectives of, the Systematic Review clearly stated? No Are sufficient details of the methods and analysis provided to allow replication by others? No Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: urology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ismail MB. Reviewer Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r369552 ) The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-369552 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Feb 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 2 (revision) 07 Jul 25 read read Version 1 10 Feb 25 read read Mohammed Bassil Ismail , University of Baghdad, Baghdad, Iraq Niwanda Yogiswara , Airlangga University, Surabaya, Indonesia Phyllis Yan , University of Michigan, Ann Arbor, USA Yu-Ren Huang , Case Western Reserve University, Cleveland, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Huang Y. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Oct 2025 | for Version 2 Yu-Ren Huang , Case Western Reserve University, Cleveland, Ohio, USA 0 Views copyright © 2025 Huang Y. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Overall, I find the manuscript is well written and suitable for indexing. Minor Revisions: In some of the studies listed, the location and size of the stones were missing per table 2 shown. The author indicated the limitation of the studies, however, if the subgroups of stones can be analyzed, it would be helpful to address the heterogeneity and bias. The baseline characteristics of the included studies should be described in more detail. It would be valuable to include variables such as the hospital setting, patient ethnicity, geographical background and the stone related history to provide better context of the participants. The manuscript currently reports complication rates without clearly differentiating whether these complications are directly attributable to the extracorporeal shock wave lithotripsy procedure or are sequelae related to the underlying stone disease (e.g., symptoms from stone passage or pre-existing infections). Consider including the specific timeframe for included studies (e.g., from year X to 2024) for completeness. Are the rationale for, and objectives of, the Systematic Review clearly stated? Partly Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Urology, Genetics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Huang YR. Peer Review Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r416537) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-416537 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Yan P. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 08 Oct 2025 | for Version 2 Phyllis Yan , University of Michigan, Ann Arbor, Michigan, USA 0 Views copyright © 2025 Yan P. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This is an interesting review that highlights the need for additional research to compare the use of ultrasound-guided and fluoroscopy-guided shock wave lithotripsy in treating renal and ureteral stones. I have reviewed this from a statistical perspective and identified some areas for clarity and improvement. Many of my comments are based on the latest guidelines for meta-analyses and systematic reviews in urology [1]. The comments are as follows: Major comments: Random effects analysis requires an estimate of the between study variance, and this estimate is unreliable when the number of studies is small [1]. Since the number of included studies was less than ten, the authors should use a more conservative approach such as the Hartung-Knapp-Sidik-Jonkman method to calculate the confidence intervals. As other reviewers have noted - for the analyses related to stone free rates in children and complication rates, there seems to be a large amount of heterogeneity and indeed different direction of effects between the studies, although most studies do not have significant results. Because of this, I think it makes more sense to just describe the potential sources of heterogeneity between the studies rather than to pool the results of the studies, see guidelines 4.1 and 4.2 [1]. The risk of bias for each study was assessed, but not incorporated into the findings or conclusions, see guideline 3.3 [1]. Perhaps the authors can assess the quality of evidence of the pooled results using the GRADE approach [2]. For the stone free rate analyses, I am not sure why the authors chose to present the risk ratio of a non-event, rather than the risk ratio of a stone free event. I think it would be more intuitive for the authors to present the stone-free risk ratios rather than the non-event risk ratios, and state that the overall stone free rate for US-guided SWL was higher than the stone free rate for FS-guided SWL. Either way, the authors need to clearly interpret the risk ratios throughout the text, instead of only stating that they reveal a significant or non-significant difference in overall stone-free rates between US-guided and FS-guided SWL. The authors should describe what event is being modeled, and what is the direction of the effect of US-guided SWL compared to FS-guided SWL. Minor comments: In the abstract the authors state that “A comprehensive literature search identified seven comparative articles that matched the criteria”, should this be eight? Similarly, in the results section, the authors state “We performed a quantitative analysis of seven studies, consisting of three of the children population and four of the adult population”. However, in the forest plot there seem to be five studies included for the adult population. Quality assessment: How were disagreements in data abstraction and risk of bias assessment handled? PRISMA figure: For the statements “Records identified from*”, and “Records excluded**”, what are the asterisks referring to? Statistical analysis: The statistical analysis section needs to be expanded. All the analyses performed in the study should be described here, including any subgroup analyses, and the meta-regression mentioned in the “Stone free rate” section. The authors should also state what covariates were included in the meta-regression. Statistical analysis: The authors should state the estimation method(s) used for the random effects models. Statistical analysis: The authors should report the tau 2 statistic rather than the I 2 statistic to assess heterogeneity, see guideline 4.3 [1]. Statistical analysis: The authors state that “Metanalysis was performed using a forest plot”. Metanalysis should be changed to “Meta-analysis”, and a forest plot is used to display the results from a meta-analysis, not perform the meta-analysis. Results: The abbreviation SFR should be introduced as “stone free rate (SFR)”. Stone free rate: The authors should elaborate on how the stone-free rate definition varied across studies or cite their supplementary data. Complication rate: The authors should elaborate on why they excluded one study due to outlier values. Which variable had outlier values? Complication rate: I do not see the visual presentation of the funnel plot, and the referenced figure 4 is the forest plot of the complication rate. Also, why not present a visual funnel plot for the stone free rate outcome, if there is a funnel plot for the complication rate outcome? Figures 3 and 4: The labels should say “Forest” rather than “Forrest”. Figures 3 and 4: It would be helpful to have the number of total events for US and FS shown in the “Subtotal (95% CI)” row, rather than the row below. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Partly Is the statistical analysis and its interpretation appropriate? Partly Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable References 1. Vickers A, Assel M, Dunn R, MacLennan G, et al.: Guidelines for meta‐analyses and systematic reviews in urology. BJU International . 2025. Publisher Full Text 2. Guyatt G, Oxman A, Vist G, Kunz R, et al.: GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ . 2008; 336 (7650): 924-926 Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Statistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Yan P. Peer Review Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.184222.r413988) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-181/v2#referee-response-413988 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Yogiswara N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 14 Apr 2025 | for Version 1 Niwanda Yogiswara , Airlangga University, Surabaya, Indonesia 0 Views copyright © 2025 Yogiswara N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The manuscript is generally well-written, with an appropriate length and adequate language use. The methodology is acceptable, and it is commendable that the authors have registered their review protocol in PROSPERO. Overall, I find the manuscript suitable for acceptance. However, a few minor revisions are necessary to enhance manuscript clarity. Minor Revisions: The baseline characteristics of the included studies should be described in more detail. It would be valuable to include variables such as the mean age of participants, gender distribution, hospital setting, and patient ethnicity or geographical background to provide better context of the participants. Given the operator-dependent nature of ultrasound, the reviewer suggests the authors specify who performed the ultrasound-guided SWL in the included studies — for instance, whether it was a urologist, a radiologist, or a trained nurse. There appears to be notable heterogeneity in the outcomes related to SFR and complication rates. The authors might consider exploring additional sources of this heterogeneity through subgroup analyses beyond age group — for example, by stratifying according to stone location (e.g., upper pole, renal pelvis), the number of sessions, or variations in energy and frequency settings used during shockwave lithotripsy. In terms of complications, it is unclear whether the analysis refers to overall complications or specific categories. If feasible, a subgroup analysis for individual complications (e.g., hematuria, steinstrasse) would provide valuable insights. If such analysis cannot be performed, the authors should consider addressing this as a limitation. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) No Competing Interests No competing interests were disclosed. Reviewer Expertise Urology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Yogiswara N. Peer Review Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r377157) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-377157 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 02 Apr 2025 | for Version 1 Mohammed Bassil Ismail , University of Baghdad, Baghdad, Baghdad Governorate, Iraq 0 Views copyright © 2025 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions There is substantial heterogeneity in stone-free rates among adults and complication rates, which the authors did not evaluate. • Publication bias was not assessed, specifically using a funnel plot and Egger’s test. • The authors did not provide key details on stone characteristics, including location and Hounsfield units (HFU), as well as intervention settings of the included studies. • I suggest conducting subgroup analyses by stone size and other relevant variables to explore potential sources of heterogeneity. • Due to these methodological limitations, rejection is advised. Are the rationale for, and objectives of, the Systematic Review clearly stated? No Are sufficient details of the methods and analysis provided to allow replication by others? No Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Partly If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise urology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Ismail MB. Peer Review Report For: The comparison of totally ultrasound-guided versus fluoroscopy-guided shockwave lithotripsy in renal stone treatment: a systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :181 ( https://doi.org/10.5256/f1000research.173510.r369552) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-181/v1#referee-response-369552 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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