RESUMO
Both extracorporeal shock were lithotripsy [ESWL] and ureteroscopy [URS] are well established methods in stone treatment, however the therapeutic procedure in ureteral calculi especially the distal third of the ureter is still a matter of controversy. The aim of the study was to compare the results of ESWL and URS in the treatment of distal ureteral calculi less than 1 cm in size. The study included 50 patients with distal ureteral calculi less than 1 cm, they were divided into two groups, 25 patients each. The first group was treated by ESWL using Dornier-S lithotripter while the second group was treated by URS with extraction of the stone or intracrporeal lithotripsy using the pneumatic lithotripter "The Swiss Lithoclast". Our results showed the mean operative time of URS to be less than that of ESWL. The fluoroscopy time was too much less in the URS group than the ESWL group and the stone free rate of URS to be greater than that of ESWL [the overall success rate was 92% for URS compared to 84% for the ESWL]. We concluded that URS is significantly better than ESWL in terms of operative time, fluoroscopy time and the time needed to achieve a stone free state. Disadvantages of URS are the need for stenting and the dependence on the surgical skill. So for distal ureteral calculi we recommend URS as a first line treatment