Comparison of three procedures for treatment of ureteral calculus

Objective: To compare the clinical effects of extracorporeal shock-wave lithotripsy(ESWL),ESWL with ureteral catheterization and pneumatic ureteroscopic lithotripsy(URL) in treatment of ureteral calculi.Methods: Four-hundred and fifty patients with ureteral calculi received the therapy of Dornier Compact S electromagnetic lithotripter.Three-hundred and two of them were performed ESWL,148 received ESWL with ureteral catheterization.One-hundred and twenty patients were treated with URL using Storz ureteroscope and pneumatic lithotriptor.Results: After two weeks,the stone-free rates for the calculi in the upper part of the ureter were 85.83%,89.66% and 89.36% respectively in the three groups,and the difference was not significant(P>0.05);the rates in the middle and lower part in the ESWL group with ureteral catheterization and URL group were 97.78 and 98.63%,respectively(P>0.005),which presented no obvious difference between them,but both were higher than that of 87.91% in the ESWL group(P<0.005).Conclusions: ESWL is the first choice for treatment of calculi in the upper ureter;ESWL with ureteral catheterization is effective and safe for treatment of calculi in the middle and lower part of ureteral,the effect of which is similar to URL,but superior to ESWL.