Comparison of Transurethral Ureteroscopy and Extracorporeal Shock Wave Lithotripsy for Treatment of Distal Ureter Calculi

Choi, Young Deuk; Yang, Seung Chul; Lee, Moo Sang

Abstract

Either transurethral ureteroscopy(URS) or ESWL was the primary method of intervention in patients with stones located in the ureter distal to the radiological marking of the sacroiliac joint. 185 distal ureter calculi were treated by URS and/or ESWL, and the results, morbidity and complications were compared for the efficacy and safety of each treatment modality. We report the success and morbidity rates in 112cases undergoing URS and 73cases treated with ESWL primarily. The overall success rate was comparable with both modalities, which was 89.3% in URS and 89.0% in ESWL. Patient morbidity rate as measured by length of procedure time & postoperative stay and complication was less with ESWL than with URS. In 5 cases which was failed with ESWL, all stones were removed by URS. We conclude that ESWL or URS is the successful treatment for distal ureter calculi, however, ESWL is a noninvasive, time-saving and easily applicable technique and, therefore ESWL is more effective treatment than URS. In addition, Reserving URS for the small number of distal ureteral calculi proved refractory to ESWL, the distal ureter calculi may be handled completely by a combination of these two techniques.