In a prospective fashion, transrectal ultrasonography and intravenous urogr
aphy were performed in 48 patients with distal ureteral calculi. We compare
d the ability of the two modalities to detect calculus and to determine the
size of the calculus, the degree of obstruction, and the degree of hydrour
eter. In 11 cases (23%), the calculus was not seen at intravenous urography
, while transrectal ultrasonography detected calculus in each patient. In 3
7 cases in which calculi were detected by both modalities, the average diam
eter of the calculus determined by ultrasonography was significantly larger
(P < 0.05) than that obtained by plain radiography. Positive correlations
were obtained in the assessment of degree of obstruction (correlation coeff
icient = 0.587, P < 0.05) and hydroureter (correlation coefficient = 0.794,
P < 0.05) between the two techniques. Transrectal ultrasonography appears
to be a useful adjunctive method to evaluate distal ureteral calculus, part
icularly if the results of intravenous urography are inconclusive.