title: Ureteroscopy in proximal ureteral stones after shock wave lithotripsy failure: Is it safe and efficient or dangerous?
abstract: BACKGROUND
  We assessed the effectiveness of ureteroscopy (URS) in proximal ureteral stones performed after shock wave lithotripsy (SWL) failure, and determined outcomes in terms of success rate, complications, and operation time.
  
  
  METHODS
  We analyzed data of patients with previous unsuccessful SWL (Group I) and the ones that did not have SWL or URS before (Group II) for proximal ureteral stones between December 2007 and August 2014. Group I included 346 patients who underwent complementary URS and Group II 209 patients who underwent primary URS. Success rates, operation time and complications were compared between groups.
  
  
  RESULTS
  Success rates of complementary and primary URS were 78.9% and 80.9%, respectively. The difference in success rates was not statistically significant between groups (p = 0.57). The complication rates of complementary URS was 12.1%, and 9.5% in primary URS (p = 0.49). No statistically significant differences were noted in terms of gender, age, stone size and side, or lithotripter type between groups. The mean operation time and need for balloon dilatation were higher in complementary URS group compared to the primary URS group, and the difference was statistically significant (p < 0.05).
  
  
  CONCLUSIONS
  Complementary URS may be used safely after SWL failure in proximal ureteral stones. Its success rate and morbidities are similar to primary URS, except for longer operation time and an increased need for balloon dilatation.
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey;
authors.forename: Muhammet Fatih
authors.initials: MF
authors.lastname: Kilinc
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey;
authors.forename: Omer Gokhan
authors.initials: OG
authors.lastname: Doluoglu
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey;
authors.forename: Tolga
authors.initials: T
authors.lastname: Karakan
authors.affiliation: Department of Urology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey;
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dalkilic
authors.affiliation: Department of Urology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey;
authors.forename: Nurettin Cem
authors.initials: NC
authors.lastname: Sonmez
authors.affiliation: Department of Urology, Etimesgut Military Hospital, Ankara, Turkey;
authors.forename: Yasin
authors.initials: Y
authors.lastname: Aydogmus
authors.affiliation: Department of Urology, 18 Mart University, Canakkale, Turkey.
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu