Outcome of SWL for Lower Ureteric Calculi

Abstract

Objective To determine the efficacy of
extracorporeal shock-wave lithotripsy
(SWL) in the treatment of lower ureteric
calculi.Materials and methods Patients
with lower ureteric calculi selected for
treatment by SWL from July 2006June
2011 were analyzed retrospectively. Outcomes
assessed were stone clearance,
complications and retreatment including
the need for ureteroscopy. Complications
like sepsis, hydronephrosis and deterioration
of renal function were documented.
Indications for ureteroscopy included
failure of fragmentation and failure
to clear fragments at follow up. Results
A total of 59 patients were studied.
There were 51 males and 8 females with
age ranging from 19 - 74 years (mean
age 43 years). Thirty seven patients had
left sided calculi, 21 right sided and one
patient had bilateral lower ureteric calculi.
The size of the calculi ranged from 5
to 15 mm (mean size 8.44 mm). The
number of shocks ranged from 2000 to
8000 (mean no. of shocks 4449). The
duration of follow up varied from
2 to 30 days (mean 11.4 days). Ureteroscopy
was required in 11 patients. 44 of
patients with stone size in the range 11-15
mm required ureteroscopy. Of the 11 patients,
six had ureteroscopy for failure to
fragment and five for failure of clearance.
There was no reported UTI or deterioration
of renal function during the study. Conclusion
SWL is a safe effective treatment for
lower ureteric calculi of size less than 10
mm. But for larger stones (10mm), the
rates of failure and need for intervention is
higher.