EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY IN 1,178 URETERAL CALCULI PATIENTS - LESSONS LEARNT

In the last 40 months 1, 17 8 ureteric stone patients have been treate d on the Siemens Lithostar. The commonest site was upper ureter (54%) followed by the lower (24%) and midureter (22%). Patients were stratif ied into two groups (A and B) chiefly on the basis of calculus size, d egree of back pressure changes, presence of infection and associated l ocal or systemic complicating factors. The mean number of shocks and s essions, complications, pre- and posttreatment auxiliary procedures an d failure rates were higher in group B. The overall failure rate was 1 .27 and 3.5% needed after extracorporeal shock- wave lithotripsy auxil iary procedures. We attribute our high success and low complications r ate mainly to the liberal use of JJ stent, attempt of retrograde calcu lus manipulation at the height of expiration and selection of appropri ate position for calculus localization based on stone location.