A comparison of ureteroscopy to in situ extracorporeal shock wave lithotripsy for the treatment of distal ureteral calculi

Purpose: The optimal treatment for distal ureteral calculi remains controve rsial. Most urologists offer extracorporeal shock wave lithotripsy (ESWL da gger) or ureteroscopy for stones that require intervention. We present data from our institution on these modalities since 1990. Materials and Methods: We treated 187 distal ureteral calculi with ESWL (91 cases) on a Dornier HM3 or MFL 5000 lithotriptor, or with ureteroscopy (96 cases) using basket extraction with or without pulsed dye laser lithotrips y. Results: Fragmentation and stone-free rates for ESWL were 80 and 73%, respe ctively, with no complications. For ureteroscopy the stone-free rate was 95 % with a 5.2% short-term complication rate and no long-term complications. Conclusions: At our institution ureteroscopy is more efficacious than ESWL for the treatment of distal ureteral calculi.