Treatment of ureteric stones based on a series of 152 stones.

Objective : To define the therapeutic approach to ureteric stones. Material and Methods : 137 patients with 152 ureteric stones were treated b etween January 1990 and January 1997. Sixty seven stones (44%) were situate d in the lumbar ureter, 16 stones (10%) were in the iliac ureter; 69 stones (46%) were in the pelvic ureter. These stones were treated by extracorpore al shock-wave lithotripsy (ESWL), ureteroscopy and, more rarely, ureterotom y. Results : One hundred and three stones were treated in a single session, wh ile 31 required two ESWL sessions. Treatment eliminated 82% of ureteric sto nes: 89% of lumbar ureteric stones, 31% of iliac stones and 85% of pelvic s tones. Ureteroscopy was performed as first- or second-line treatment in 34 cases. It successfully treated 97% of ureteric stones: 100% of pelvic and lumbar s tones and 91% of iliac stones. Three patients were successfully treated by ureterolithotomy for a lumbar u reteric stone and two for iliac ureteric stones. Conclusion : SWL is the reference treatment for stones of the lumbar ureter . Ureteroscopy is justified after failure of ESWL for stones of the pelvic and iliac ureter, as it gives excellent results.