Extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: A prospective randomized study

Purpose: We performed a prospective randomized study to determine appropriate first line treatment for distal ureteral stones. Material and Methods: Between January 1996 and October 1997, 80 patients with distal ureteral stones (40 smaller than 5 mm. and 40 larger than 5 mm.) were randomized and treated with extracorporeal shock wave lithotripsy or ureteroscopy with a 9.5 or 6.5F semirigid ureteroscope. Results: Ureteroscopy was significantly better in terms of operative time, fluoroscopy time and time to achieve a stone-free state. The smaller the stones, the greater the difference between the 2 treatment modalities. Conclusions: For distal ureteral stones we recommend ureteroscopy as first line treatment.