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Treatment options for distal ureteral stones
J A Boulier1, P Laguna, R P Parra
1St. Louis University School of Medicine, Division of Urology, M. O., USA.
Objective:
To review the currently available treatment modalities for distal ureteral stones and outline our protocol for management.
Methods:
Current literature on each treatment modality, from expectant management to open ureterolithotomy, and special procedures were analyzed.
Results:
Our treatment protocol for distal ureteral stones is based mainly on the stone size. Distal ureteral stones that measure 5 mm or less are best managed initially by ureteroscopy. Stones greater than 5 mm are treated initially by ESWL, with a success rate of at least 80%.
Conclusion:
The initial choice of treatment must be dictated by the practical concerns of available equipment, experience of the surgeon and cost of treatment. The trend is initial management by ESWL, although recent studies show better results in terms of cost for ureteroscopy.