Extracorporeal shock wave lithotripsy in the management of upper third ureteral stones

From January 1986 to March 1988, 177 patients with 180 upper third ureteral stones (located at L3, L4, or L5 level) received extracorporeal shock wave lithotripsy (ESWL) in Veterans General Hospital-Taipei. The average size of stones was 10.4 mm. Seventy-seven percent of patients received one session of ESWL, twenty percent two sessions and three percent three sessions. One hundred and thirty-four cases (74.4%) had preoperative reposition of stones. The over-all success rate, being 78.3%, was significantly related to the size of stones, result of reposition, and severity of hydronephrosis and renal function impairement (Pearson's coefficient less than 0.05). For more rational use of ESWL, we suggest that if the failure in the reposition of the ureteral stone happens in company with other poor prognostic factors such as the stone size larger than 15 mm, severe hydronephrosis or renal function impairement other regimens should be tried instead.