Success and challenges of ESWL for managing distal ureteric stones of 5-15 mm size

Extracorporeal shock wave lithotripsy (ESWL) is widely recognized as a safe, non-invasive treatment with minimal side effects. This procedure does not require anesthesia, making it an effective option for lower ureteral stones. This study aimed to assess the effectiveness of ESWL in treating distal ureteral stones ranging from 5 to 15 mm in size and to identify factors influencing the treatment outcomes.

This was a prospective hospital-based analytical cross-sectional study conducted in the Department of Urology, tertiary care facility, Jaipur. Data collection for the study was started in September 2023 and completed in November 2024. A total of sixty one patients diagnosed with distal ureteral stones and undergoing ESWL treatments were enrolled in this study. The data was analyzed using SPSS 25.0 version.

The average age of the participants was 49.52 ± 10.99 years, with approximately two-thirds being male. The mean stone size was 9.93 ± 2.95 mm, and the average stone density was 765.10 ± 205.88 HU. The overall success rate of the procedure was 85.2% (n = 52/61). Treatment success was significantly associated with age, stone size, and BMI (p < 0.05), but not with the patient's sex or stone laterality (p > 0.05). In the multivariate analysis, the patient's BMI was identified as the only significant predictor of treatment success.

ESWL is a successful, non-invasive, and practical therapeutic option for lower ureteric calculi with no significant side effects. It is an effective procedure for small size ureteric calculi up to 15 mm size, ESWL could therefore be used as the main form of treatment.