Extracorporeal shock wave lithotripsy in situ treatment for ureteral stones

Three hundred and sixteen patients with ureteral stones were treated in situ (without retrograde stone manipulation) with and without stent bypass (DJ stent, ureteral catheter). Results were generally better with stent bypass, but only marginally so for stones larger than 10 mm in diameter. Regardless of whether or not the ureter was stented, lower ureteral stones were more difficult to fragment than upper ureteral stones and pre-sacral stones did not respond well to in situ treatment. We observed that evaluation of stone disintegration and fragment evacuation could only be properly assessed after approximately 3 weeks post-ESWL.