title: A comparison of extracorporeal shock wave lithotripsy and ureteroscopy under intravenous sedation for the management of distal ureteric calculi.
abstract: BACKGROUND
  We have performed a study to compare shock wave lithotripsy (SWL) and ureteroscopy under intravenous sedation for the management of distal ureteric calculi.
  
  
  METHODS
  Patient tolerance, procedure times and treatment outcomes were prospectively evaluated in 110 patients undergoing 138 SWL treatments, and 172 patients undergoing ureteroscopy under intravenous sedation for the management of distal ureteric calculi.
  
  
  RESULTS
  Men tolerated SWL better than ureteroscopy. Over 90% of women tolerated both procedures well. Procedure times were 52 minutes for SWL and 27 minutes for ureteroscopy. Treatment was successful in 72% of patients undergoing SWL, and 95% of patients undergoing ureteroscopy.
  
  
  CONCLUSIONS
  In women with distal ureteric calculi requiring treatment, we recommend ureteroscopy under intravenous sedation as the treatment of first choice. In men the better tolerance of SWL must be weighed against the higher success rate of ureteroscopy. If both treatment modalities are available, patients with small distal ureteric calculi, in whom ureteroscopy is likely to be successful, should be informed of and offered their choice of either treatment modality.
authors.affiliation: The Department of Surgery, Section of Urology, University of Manitoba, and Adult Ambulatory Care, Section of Urology, Health Sciences Centre, Winnipeg, Manitoba, Canada.
authors.forename: Denis H
authors.initials: DH
authors.lastname: Hosking
authors.forename: Wilda E
authors.initials: WE
authors.lastname: Smith
authors.forename: Sherrell E
authors.initials: SE
authors.lastname: McColm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy