PURPOSE: To describe the use of vaginal ultrasonography to identify di
stal ureteral calculi and hydroureter. MATERIALS AND METHODS: Abdomina
l and vaginal sonography were performed in 13 women with distal ureter
al calculi. Indications for sonography included flank pain, hematuria,
and suspected appendicitis. Six patients were pregnant. RESULTS: In e
ach patient, vaginal sonograms demonstrated a distal ureteral calculus
; in only two cases was the calculus detected with transabdominal sono
graphy. Distal hydroureter was identified with vaginal scanning in eac
h patient but with abdominal scanning in only two. Hydronephrosis was
absent in three patients, mild in six, and moderate in four. Symmetric
ureteral jets were noted at transabdominal sonography in two of nine
patients. Follow-up transvaginal scans obtained shortly after passage
of stones in two patients revealed swelling of the trigone but normal
ureteral jets. CONCLUSION: In symptomatic female patients, use of vagi
nal sonography should be considered to evaluate the distal ureter for
calculi, particularly if the results of transabdominal examination are
normal or inconclusive.