Management of lower ureteric stones: a prospective study

OBJECTIVE: To discuss the current concepts in lower ureteric stone management. MATERIAL AND 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. CONCLUSION: 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.