Proximal ureteral calculi: shock wave or ureterolithotripsy?

To compare the success rates and efficiency of ureterolithotripsy (URL) and extracorporeal shock wave lithotripsy (SWL) for proximal ureteric stones. CASUISTRY AND METHODS: A prospective non-randomized study was performed between 1999 and 2004. Of a total of 235 patients, 121 underwent SWL and 114 had ureteroscopy with ultrasonic lithotripsy. There were no significant differences between the groups. The success rate, operative time, postoperative pain and complications were analyzed in each group. Patients were followed postoperatively for a minimum of 3 months (median 6 months).

Treatment success rate was defined as the complete removal or as the radiographic absence of calculi at a 3-month follow-up. The URL success rate was 85.6% (98/114) and 89.5% (68/95) after one SWL session and (77/85) 90.6% after a second treatment. No differences were found in the results, overall complication rates and mean procedure time. However, the fluoroscopy time was longer in the URL group and pain was more frequent.

Semirigid URL is as efficient as SWL in the treatment for proximal ureteral stone. However, SWL requires less fluoroscopic time and fewer pain relievers.