Effectiveness and safety of external physical vibration lithecbole for upper urinary stone expulsion: a systematic review and meta-analysis

Yifan Huang^1,2,#, Bingzhi Han^2,#, Zikai Huang^1,2, Qianhao Huang², Tao Wang^2,*, Yuedong Chen^1,2,*
1 The Graduate School of Fujian Medical University, Fuzhou, China
2 The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
* Corresponding Author: Tao Wang. Email: email ; Yuedong Chen. Email: email
# These authors contributed equally to this work
(This article belongs to the Special Issue: Urolithiasis in Focus: Integrated Perspectives on Infection, Metabolic Dysfunction, and Contemporary Management)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.070466

Received 16 July 2025; Accepted 03 February 2026; Published online 03 March 2026

Abstract

Objectives: The external physical vibration lithecbole (EPVL) is a new device. It is clinically employed to improve the stone-free rate (SFR). However, it is not widely accepted in clinical practice due to the lack of high-level evidentiary support and a standard protocol. This study aimed to evaluate the effectiveness and safety of external physical vibration lithecbole (EPVL) as an adjunct to extracorporeal shock wave lithotripsy (ESWL) or retrograde intrarenal surgery (RIRS) for upper urinary tract stones. Methods: We systematically searched PubMed, Web of Science, Embase, the China National Knowledge Infrastructure (CNKI), and the Cochrane Library from inception to 13 January 2026, for randomized controlled trials (RCTs) comparing EPVL plus standard care with standard care alone, and we pooled relative risks (RR) with 95% confidence intervals (CI). Results: Nine RCTs involving 1418 patients were analyzed. Compared with standard care alone, EPVL significantly increased early stone-free rates at about 1 week (RR 1.44, 95% CI 1.18–1.77, p < 0.001) and 2 weeks (RR 1.40, 95% CI 1.20–1.63, p < 0.001) after ESWL or RIRS, with greater benefit for lower-pole (RR 1.56, 95% CI 1.25–1.96, p < 0.001) and renal pelvic stones (RR 1.54, 95% CI 1.10–2.14, p = 0.01). EPVL was associated with a lower rate of overall complications (RR 0.58, 95% CI 0.46–0.73, p < 0.001); specifically, it was linked to lower risks of hematuria (RR 0.64, 95% CI 0.48–0.86, p = 0.002) and urinary tract infection-related findings (RR 0.28, 95% CI 0.14–0.57, p < 0.001). Conclusions: Adjunctive EPVL improves short-term stone clearance after ESWL or RIRS without adding measurable risk and may also be associated with a reduced incidence of complications. Where available, EPVL can be considered as a non-invasive option to enhance fragment clearance, particularly for lower-pole renal stones. Further multicenter trials are needed to confirm long-term outcomes and generalizability. Trial Registration: PROSPERO CRD42024600537