The Efficacy Of Comparison Of Extracorporeal Shock-wave Lithotripsy Versus Ureteroscopic Pneumatic Lithotripsy For Distal Ureteric Calculi

Objective:To determine the optimal treatment for the distal ureteric calculi bycomparison of ESWL and UR-PL.Methods: The clinical data of152patients of distal ureteric calculi treated byESWL and other124by UR-PL from June2003to December2011were reviewedretrospectively by the evaluation of the stone-free rate on48hours and on one month、the incidence of complicatio（nincluding fever、renal colic、ureteral perforation and grosshematuria）and retreatment rate.Results: For distal ureteric calculi（≥1cm），stone-free rate on48hours in UR-PLgroup was68.75%while46.51%in ESWL group(P＜0.05)；Stone-free rate after onemonth in UR-PL group and in ESWL group was93.75%and79.07%,respectively.(P＜0.05)；The fever rate in UR-PL group was6.25%while in ESWL group was20.93%(P＜0.05)；The renal colic rate in UR-PL group was14.58%while in ESWL group was34.88%(P＜0.05)；The ureteral perforation rate in UR-PL group was2.08%while inESWL group was0(P＞0.05)；The gross hematuria rate in UR-PL group was95.83%while in ESWL group was88.37%(P＞0.05)；The re-treatment rate in UR-PL groupwas10.42%while in ESWL group was32.56%(P＜0.05)。For distal ureteric calculi（＜1cm），stone-free rate on48hours in UR-PL group was81.58%while78.90%inESWL group(P＞0.05)；Stone-free rate after one month in UR-PL group and in ESWLgroup was96.05%and95.41%,respectively (P＞0.05)；The fever rate in UR-PL groupwas5.26%while in ESWL group was12.84%(P＞0.05)；The renal colic rate inUR-PL group was3.94%while in ESWL group was6.42%(P＞0.05)；The ureteralperforation rate in UR-PL group was1.13%while in ESWL group was0(P＞0.05)；Thegross hematuria rate in UR-PL group was93.42%while in ESWL group was87.16%(P＞0.05)；The retreatment rate in UR-PL group was5.26%while in ESWL group was10.09%(P＞0.05). Conclusion: It is recommended that ESWL be the preferred treatment for patientswith distal ureteric stones of＜1cm and UR-PL for patients with stones of≥1cm.