Background. The efficacy of ESWL and ureteroscopy in the treatment of lower ureteric stone is still
discussed. The aim of the study is to compare efficacy and safeness of both methods.
Methods and Results. A retrospective study comparing the treatment results of distal ureteric stones
was performed. The inclusion criteria were: distal ureteric stones with no previous treatment and an
accomplished three months follow-up after the treatment. There were 395 cases (390 patients) included
in the ESWL group and 509 cases (501 patients) in the ureteroscopy group.
Higher efficacy of ureteroscopy as opposed to ESWL therapy was marked. There is no significant difference
in stone free rate in three months after the treatment (97.72 % vs. 98.40 %, p=0.4675), but there
is a significant difference in EQ according to Rassweiler (43.52 vs. 89.60, p<0.0001). The main difference
is in evaluation in 48 hours after the treatment (stone free rate 64.81 % vs. 96.46 %, p<0.0001).
Ureteroscopy has a higher incidence of complications during the therapy 0.67 % vs. 6.36 %, p<0.0001)
as well as after the therapy (6.55 % vs. 11.95 %, p=0.0018), but the complications are minor. On the contrary
ESWL treatment is accompanied by a higher re-treatment rate (51 % vs. 2 %, p<0.0001) and higher
incidence of auxiliary procedures (25.87 % vs. 6.36 %, p<0.0001).
Conclusions. It has been clearly proven that ureteroscopy is more efficient in the treatment of distal ureteric
stones than ESWL. The main advantage of ureteroscopy is the immediate effect, low re-treatment
rate and low incidence of auxiliary procedures, except the need of removing the J-J stent. The disadvantage
of ureteroscopy is the requirement of general anaesthesia and a higher incidence of complications
after the treatment, though only minor ones in most of the cases.
ureteric stone, therapy, ESWL, ureteroscopy.