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Objectives To determine the optimal method of treatpreference or the availability of urgent ESWL. The success rate was measured by the disintegration of ment for ureteric stones causing complete obstruction, treated by insertion of a JJ stent or a nephrostomy the stone and spontaneous passage after ESWL; failure was defined as the need for additional procedure(s) for tube, followed by extracorporeal shock wave lithotripsy (ESWL) or by urgent in situ ESWL if readily stone extraction. Results Urgent in situ ESWL (group 3) had a median available.Patients and methods The study comprised a retrospec-(95% confidence interval) success rate of 81 (54-96)%, compared with 70 (53-83)% in group 2 tive analysis of 82 consecutive patients who presented with ureteric stones causing complete obstruction.and 54 (33-73)% in group 1. Conclusion If facilities are available, urgent in situ ESWL Twenty-six had a percutaneous nephrostomy (PCN, group 1) and 40 had a JJ stent (group 2) placed to appears to be the choice of treatment for obstructing ureteric stones. If such facilities are not available, a relieve the obstruction, and the stones were subsequently treated by ESWL. Sixteen patients under-JJ stent may oCer better success than a PCN. A prospective controlled trial is necessary to confirm went urgent in situ ESWL without recourse to either a JJ stent or a PCN (group 3). The choice of the these findings.