Extracorporeal shock wave lithotripsy in 1,178 ureteric calculi patients--lessons learnt

In the last 40 months 1,178 ureteric stone patients have been treated on the Siemens Lithostar. The commonest site was upper ureter (54%) followed by the lower (24%) and midureter (22%). Patients were stratified into two groups (A and B) chiefly on the basis of calculus size, degree of back pressure changes, presence of infection and associated local or systemic complicating factors. The mean number of shocks and sessions, complications, pre- and posttreatment auxiliary procedures and failure rates were higher in group B. The overall failure rate was 1.27 and 3.5% needed after extracorporeal shock wave lithotripsy auxiliary procedures. We attribute our high success and low complications rate mainly to the liberal use of JJ stent, attempt of retrograde calculus manipulation at the height of expiration and selection of appropriate position for calculus localization based on stone location.