Ureteric Stone Size Dictates Best Therapy

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Extracorporeal shockwave lithotripsy (ESWL) may be a better treatment option than ureteroscopy (URS) for distal ureteric stones smaller than 1 cm, according to researchers at University Frederico II in Naples, Italy.

Among 273 patients with single, monolateral, radiopaque, distal ureteric stones ranging in size from 0.5-1.5 cm., those randomized to undergo ESWL achieved a 92.7% overall stone-free rate compared with 94.9% for those treated with URS. However, the need for retreatment and auxiliary procedures as well as the incidence of complications was significantly higher in ESWL patients with stones greater than 1 cm in diameter than for other ESWL patients. For ESWL patients with stones 1 cm or less in diameter, the need for retreatment and auxiliary procedures as well as the incidence of complications were significantly lower than seen with URS, researchers reported in BJU International (2010;106:1748-1752).

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