Extracorporeal shock-wave versus pneumatic ureteroscopic lithotripsy in treatment of lower ureteral calculi.
OBJECTIVE
To compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi.


METHODS
From August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5 approximately 9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence.


RESULTS
The stone clearance rate was 78.1 % with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<0.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant.


CONCLUSIONS
Though the selection of these two options depends on equipments available and the expertise of the operator, we recommend URS as the optimal treatment for distal ureteral calculi.
Zeng
Guang-Qiao
GQ
Department of Urology, First Municipal People's Hospital, Guangzhou 510180, China. zgqiao@21cn.com
Zhong
Wei-De
WD
Cai
Yue-Bin
YB
Dai
Qi-Shan
QS
Hu
Jian-Bo
JB
Wei
Hong-Ai
HA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*