Management of lower ureteric stones: a prospective study.
OBJECTIVE
To discuss the current concepts in lower ureteric stone management.


METHODS
Between October 2008 and November 2010, 190 patients of both sexes and of different age groups with lower ureteric stones, underwent in situ extracorporeal shock wave lithotripsy (ESWL) (48 cases), ureterorenoscopy (URS) (120 cases) and open stone surgery (OSS) (22 cases). The patients' clinical and radiological findings, as well as stone characteristics, were reviewed and correlated with the stone-free status.


RESULTS
In the ESWL group, the operative time was 43.13 +22.5 min; the average number of sessions/patients was 1.5 sessions; the average number of SW/patients was 4500 SW/patients; the average energy was 16.5 kV; the average stone burden was 7.8/mm; the overall stone-free rate was 75% (36/48); and the average radiation exposure time was 3.5 min. In the URS group, the operative time was 49.21 +16.09 min; the average stone burden was 10.81mm; the overall stone-free rate was 97.5% (117/120); the average hospital stay was 3.99 days; and the average radiation exposure time was 0.75 min. In the OSS group, the operative time was 112.38 +37.1 min; the overall stone-free rate was 100% (22/22); and the average hospital stay was 9.74 days.


CONCLUSIONS
In the management of patients with lower ureteral stones, URS, SWL and OSS were considered acceptable treatment options. This recommendation was based on the stone-free results, morbidity and retreatment rates for each therapy.
Jackson Health System, Miami, FL, USA.
Mohamed
M
Etafy
Faculty of Medicine, Urology Department, Al-Azhar University, Assiut, Egypt.
Gamal A M
GA
Morsi
Faculty of Medicine, Urology Department, Al-Azhar University, Assiut, Egypt.
Mansour S M
MS
Beshir
Faculty of Medicine, Urology Department, Al-Azhar University, Assiut, Egypt.
Sheri S
SS
Soliman
Faculty of Medicine, Urology Department, Al-Azhar University, Assiut, Egypt.
Hussein A
HA
Galal
Universidad Central de Venezuela, Escuela de Medicina Luis Carreño, Caracas, Venezuela.
Cervando
C
Ortiz-Vanderdys
OSS; SWL; URS; management; stones; ureter