Ureteroscopy or extracorporeal shock wave lithotripsy for lower ureteric stone

ABSTRACT

The optimal treatment for distal ureteric stories still controversial. While most urologists offer extracorporeal shock wave lithotripsy [ESWL], others strongly prefer .ureteroscopy with or without mechanical fragmentation as the primary choice for treatment of lower ureteric stones. We present data from our department on these new modalities since 1998 to 2003. We treated 150 patients with distal ureteric calculi on Siemens modularis lithotriptor and 150 patients by ureteroscopy using forceps s, baskets or pneumatic lithoclast. Stone free rate three months post-ESWL was 90% with no complications. In ureteroscopic group of patients, the stone free rate was 95% with overall complications in 10 patients [6.7%] At our department, ureteroscopy with or without mechanical, fragmentation of lower ureteric stones is more efficacious method than ESWL, However the rarity of anaesthesia requirement and the absence of complications make ESWL as good as ureteroscopy. Our results may put ESWL as the second and in certain particular cases the first option in treatment of lower ureteric calculi