Abstract: | Second generation local shockwave lithotripsy appliances (Lithostar) were used for the treatment of upper and lower ureteral stones in 199 patients, 145 of whom had upper ureteral stones. In 78 patients the calculi were pushed back and all but one disintegrated. In 33 patients a catheter was inserted past the stone, which resulted of primary disintegration in 66%. In 19 of 34 patients (56%) in whom the stones could not be moved, primary disintegration was achieved. Distal ureteral stones were present in 54 patients and these were treated successfully by ESWL alone in 83.3%. Auxiliary measures (total 10%) included ureteroscopy, percutaneous extraction and ureterolithotomy. The results are discussed under the aspects of 'in situ' versus 'push-and-smash' procedures. |