Treatment options for distally located ureteral stones-our experience

Purpose: To compare the efficacy of different treatment strategies for distal ureteral stones. Material and Methods: A total 161 patients were included in the study. Based on the treatment modality, patients were divided into four groups. Patients in group 1 (n=38) with stone size of ≤ 10 mm2 only received conventional treatment including daily hydration of 2500 mL, ciprofloxacin, diclofenac sodium and a spasmolytic agent; group 2 patients (n=39) with stone size of ≤ 10 mm2 received conventional treatment as in group 1 and tamsulosin 0.4 mg orally daily for 4 weeks; and. Group 3 (n=33) with stone size of ≤ 15 mm2 underwent extracorporeal shock wave lithotripsy (ESWL), Group 4 (n=51) with stone size of ≤ 15 mm2 underwent ureteroscopy. Following treatment, all groups were compared in terms of stone-free rate and time to expulsion. Results: Following treatment, the stone-free rates for groups 1, 2 , 3 and 4 were 47.37%, 56.41%, 63.64 % and 94.12% (P < .0001) respectively. The mean expulsion times for groups 1, 2, 3 and 4 were 15.04 ± 3.80, 15.12 ± 2.45, 7.56 ± 4.31 and 1.95 ± 1.08 days respectively (P < .0001). Compared to the other treatments, the stone-free rate and mean expulsion time in the ureteroscopy group were significantly increased and decreased respectively. Conclusion: There are several treatment options for distal ureteral stones. Based on our data, we conclude that ureterorenoscopy should be the standard of care for distal ureteral stones.