Treatment of Lower Ureteral Calculi with Extracorporeal Shock Wave Lithotripsy

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Abstract
A group of 70 patients presenting with stones in the lower third of the ureter was treated with extracorporeal shock wave lithotripsy using a Dornier HM3 lithotriptor. For adequate radiological stone visualization a sitting position was used in 68 patients, while 2 with calculi overlying the sacroliac joint required placement in the prone position. All but 1 patient had additional endoscopic maneuvers before treatment, consisting of the passage of a Zeiss sling around the stone in 40 and, when this was not possible, a ureteral stent in 29. The over-all success rate was 94.2 percent (66 of 70 patients) with 3 patient having retained fragments and 1 requiring an open operation. The combination of new positioning techniques and relatively simple endoscopic maneuvers makes treatment of lower ureteral stones feasible and safe with the Dornier lithotriptor.