Comparative study of extracorporeal shock wave lithotripsy outcomes for proximal and distal ureteric stones

Abstract

ESWL outcomes for the ureteral calculi support the use of lithotripsy particularly for stones <100 mm(2). Treatment efficacy was not significantly different among stones localized in proximal and distal ureters. Degree of obstruction did not affect the ESWL outcomes in the proximal ureter, but it adversely affected SFR in the distal ureter.

What are the Benefits and Harms of Ureteroscopy Compared with Shock-wave Lithotripsy in the Treatment of Upper Ureteral Stones? A Systematic Review

“…Because of its noninvasive and practical nature, SWL has been the preferred therapeutic option [6][7][8], but its success depends on the location of the treated stone(s), with greater success in the management of proximal ureteral calculi. The success rates tend to decrease for distal stones, while stones treated in an emergency setting have a high success rate, similar to those treated with delayed lithotripsy [6][7][8][9][10][11][12].…”

“…The success rates tend to decrease for distal stones, while stones treated in an emergency setting have a high success rate, similar to those treated with delayed lithotripsy [6][7][8][9][10][11][12]. However, the clinical introduction of URS has significantly changed the treatment concepts for ureteral stones.…”

Urological Aspects of Management

“…Conflicting data are presented in a review comparing stone-free rates of 44 proximal and 24 distal ureteral stones. With a similar mean number of shocks delivered, the proximal stones were treated successfully in 86.3% of cases, not significantly different from the 79.1% stone-free rate in cases of distal stones (P = 0.17) [77]. Stone fragility, as determined by the acoustic and mechanical properties corresponding to the chemical composition of the stone, directly influences the success of SWL.…”

The Influence of Stone Size, Skin to Stone Distance and Hydronephrosis on Extracorporeal Shock Wave Lithotripsy Session and Shock Wave Numbers in Ureteral Stones

“…Many studies showed that the likelihood of SWL treatment failure increases with more severe obstruction [12,13]. It was reported that in patients with proximal and distal ureteral stone the SWL outcome was affected by hydronephrotic grade [14,15]. In contrast to these reports, some authors concluded that urinary obstruction does not affect the success in terms of stone clearance with SWL [16,17].…”