Treatment of Ureteral Calculi by Extracorporeal Shock Wave Lithotripsy in a Multi-Use Center

Abstract

We reviewed our experience with extracorporeal shock wave lithotripsy therapy in 138 patients who presented with mid and upper ureteral calculi. In the patients who had successful stone manipulation back into the renal collecting system, the success rate was significantly higher when compared to patients with stones treated primarily within the ureter (92.8% v 80.8%, p < 0.05). For the stones which were treated within the ureter, the success rate appeared similar for stones treated in situ (83.3%), compared to those cases where a catheter could be placed alongside the calculus (79.3%).

Higher voltage and more shock waves were administered to stones treated within the ureter as compared to stones which were manipulated back into the kidney prior to ESWL. However, this increased power did not enhance the success rate. In addition, it appears that a plain film of the abdomen obtained within 24 hours of lithotripsy treatment is a good predictor of success as defined by the stone-free rate at six-week follow-up.

Our results from a community-based multi-use lithotripsy center suggest that ureteral stone manipulation should be attempted prior to ESWL therapy for mid and upper ureteral calculi.