A comparison of ureteroscopy to in situ extracorporeal shock wave lithotripsy for the treatment of distal ureteral calculi.

Abstract

The optimal treatment for distal ureteral calculi remains controversial. Most urologists offer extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy for stones that require intervention. We present data from our institution on these modalities since 1990. We treated 187 distal ureteral calculi with ESWL (91 cases) on a Dornier HM3 or MFL 5000 lithotriptor, or with ureteroscopy (96 cases) using basket extraction with or without pulsed dye laser lithotripsy. Fragmentation and stone-free rates for ESWL were 80 and 73%, respectively, with no complications. For ureteroscopy the stone-free rate was 95% with a 5.2% short-term complication rate and no long-term complications. At our institution ureteroscopy is more efficacious than ESWL for the treatment of distal ureteral calculi.