Ureteric Stones: The Choice of Treatment

The advent of extracorporeal shock-wave lithotripsy (ESWL) has revolutionized the treatment of renal stones. Upper ureteric stones can be pushed back to the kidney prior to ESWL or percutaneous surgery but the ‘push-back’ is not always successful. Stones in the mid- and lower-ureter may be disintegrated and removed endoscopically by transurethral endoscopy. This technique may also fail in a significant proportion of cases and can have a high complication rate. The use of primary in situ ESWL for the treatment of ureteric stones (ESWL without prior stone manipulation) thus looks to be an attractive proposition because it is totally non-invasive.