In-situ ESWL in the treatment of ureteral stones

Abstract

— 185 patients with ureteral stones were treated with ESWL (118 with lumbar ureteral stones, 63 pelvic, 4 sacroiliac). 182 patients (98.3%) were treated with ESWL in-situ by means of a Dornier MFL-5000 lithotriptor. Stone size varied from 0.6 to 1.4 cm (mean 0.9 cm); 145 patients (86.9%) were stone-free after one treatment. The re-treatment rate was 13% for lumbar ureteral stones, 25% for sacroiliac and 12.5% for pelvic stones. We report no complications. 11 patients (6.04%) had to be treated subsequently with ureteroscopic fragmentation and 4 (2.19%) with open surgery. We conclude that in-situ ESWL is also a safe and effective treatment for distal ureteral stones, for which ureteroscopy is also a successful technique but with higher morbidity, and should therefore be performed in case of failure of ESWL. We have more chance of success if the in-situ treatment is performed as soon as possible.