A modified algorithm for the management of ureteral calculi: 100 consecutive cases

Area of Science:

• Urology
• Nephrology
• Endourology

Background:

• Ureteral calculi (kidney stones) present a significant clinical challenge.
• A standardized treatment algorithm is crucial for efficient management.
• Previous methods lacked a consistent approach for diverse stone locations.

Purpose of the Study:

• To evaluate the efficacy of a previously described algorithm for treating ureteral calculi.
• To assess the success rates of endourological interventions based on stone location.
• To refine treatment strategies for ureteral calculi management.

Main Methods:

• A prospective study of 100 consecutive patients with ureteral calculi requiring intervention.
• Classification of calculi by location: ureteropelvic junction, upper, mid, and lower ureter.
• Application of a treatment algorithm involving ureteroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL), with or without ureteral stenting.

Main Results:

• Successful treatment was achieved in all 100 patients.
• 98% of patients were treated with endourological methods (URS or ESWL); only 2 required open surgery.
• Lower ureteral calculi (44) were all successfully treated with URS.
• A total of 125 procedures were performed across 100 patients.

Conclusions:

• The developed algorithm provides an effective strategy for managing ureteral calculi based on their location.
• Endourological approaches, particularly ureteroscopy for lower ureteral stones, demonstrate high success rates.
• The algorithm facilitates efficient and minimally invasive treatment, reducing the need for open surgery.