Abstract
Until recently, the indications for extracorporeal shock wave lithotripsy (ESWL) have been limited to renal calculi and ureteral calculi above the pelvic brim. However, the distal ureter can be made available for shock wave treatment as well, by modifying the position of the patient on the support of the Dornier lithotripter HM-3. Using this “sitting position” technique, 133 patients with stones or stone fragments in the lower ureter were treated from January through November 1986. Treatment was successful in 125 patients (94%), 14 of whom required 2 sessions. In 8 patients, treatment failed and stone removal was accomplished using ureteroscopy or open surgery. No complications or adverse side effects were encountered in the entire series. We consider ESWL the treatment of choice in the management of distal ureteral calculi and Steinstrassen.
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