Extracorporeal shock wave lithotripsy and the ureteral stone brush: initial results

We present the initial results of a ureteral stone brush used in conjunction with extracorporeal shock wave lithotripsy for impacted ureteral stones. We studied 31 cases of ureteral calculi that could not be manipulated back into the renal collecting system. In 18 cases a ureteral catheter was placed past the calculus, while in 13 a catheter could not be passed. With the stone brush unbypassed stones yielded a success rate similar to that for bypassed stones (84.6 versus 88.9%, respectively). We believe that this result is due to the ability of the stone brush to remove circumferential fragments from around the stone, allowing more shock energy to reach the core of the stone.