TREATMENT OF URETERAL CALCULI BY EXTRACOPOREAL SHOCK WAVE LITHOTRIPSY

We reviewed 465 cases of ureteral calculi treated at Jomo Urological Hospital using a Dornier HM3 lithotripter during the period from October 1985 to February 1989. The 336 men and 122 women ranged from 11 to 78 years old with a mean age of 42.2. The stone size ranged from 4 mm to 30 mm with a mean length of 10.6 mm. Complete stone elimination by ESWL was achieved in 431 of the 465 cases (92.7%). The success rate was best for stones in the lower ureter, which was 98.1 per cent (53/54). For upper and mid ureteral calculi it was 92.4 per cent (363/393) and 83.3 per cent (15/18), respectively. ESWL after push up made 100 per cent (30/30) of patients completely free of stones, while ESWL after bypass 93.0 percent (106/114) and ESWL in situ 91.9 per cent (295/321). The rate of residual stone increases in proportion to the age of patients. Minor side effects such as fever and pain were observed. Our results suggest that ESWL currently is the first therapeutic option for the majority of ureteral calculi.